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BALM OF GILEAD HEALTHCARE CLINIC LLC
NPI 1154022895
Nurse Practitioner - Psychiatric/Mental Health in East Grand Forks, MN

Active since March 10, 2023
210 GATEWAY DR NE STE 1, EAST GRAND FORKS, MN 56721(218) 207-2020(800) 582-1083 Get Directions Write a Review

NPPES record last updated: February 10, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 10, 2025, Mar 10, 2023 (2 updates tracked since 2023).

About Balm Of Gilead Healthcare Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BALM OF GILEAD HEALTHCARE CLINIC LLC (NPI 1154022895) is a healthcare organization registered as a psychiatric/mental health in East Grand Forks, Minnesota and active in the NPI registry since March 2023. The organization lists Merit Fongwi Laduna Fondong, Np, as its authorized official.

NPPES Registry Identity

NPI1154022895
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameBALM OF GILEAD HEALTHCARE CLINIC LLC
Location Address210 GATEWAY DR NE STE 1East Grand Forks, MN 56721-1621
Mailing Address210 Gateway Dr Ne Ste 1East Grand Forks, MN 56721-1621 · (218) 207-2020
Phone(218) 207-2020
Fax(800) 582-1083
Organization SubpartNo
Authorized OfficialMerit Fongwi Laduna FondongNp · (218) 779-9437
Enumeration DateMarch 10, 2023
Last NPPES UpdateFebruary 10, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 10, 2025
✔ NPI 1154022895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X
210 GATEWAY DR NE STE 1, East Grand Forks, MN 56721
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Balm Of Gilead Healthcare Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Balm Of Gilead Healthcare Clinic LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Muluh Fondong, NP
Nurse Practitioner
NPI 1306221460
210 GATEWAY DR NE STE 1
East Grand Forks, MN 56721
(218) 207-2020
✔ PECOS✔ Accepts MedicareSame address
Kimberly Williams, APRN, FNP-C
Nurse Practitioner
NPI 1639693864
210 GATEWAY DR NE STE 1
East Grand Forks, MN 56721
(218) 207-2020
✔ PECOS✔ Accepts Medicare0.1 mi
Timothy Etonde, DNP
Nurse Practitioner
NPI 1811787666
860 S COLUMBIA RD
Grand Forks, ND 58201
(701) 780-5000
✔ PECOS✔ Accepts Medicare2.8 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Balm Of Gilead Healthcare Clinic LLC's NPI number?

The NPI number for Balm Of Gilead Healthcare Clinic LLC is 1154022895. It was assigned to this organization in the NPPES registry on March 10, 2023.

Where is Balm Of Gilead Healthcare Clinic LLC located?

Balm Of Gilead Healthcare Clinic LLC is located at 210 Gateway Dr NE Ste 1, East Grand Forks, MN 56721. The listed phone number is (218) 207-2020.

What is Balm Of Gilead Healthcare Clinic LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Balm Of Gilead Healthcare Clinic LLC enrolled in Medicare?

Yes. Balm Of Gilead Healthcare Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Balm Of Gilead Healthcare Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Balm Of Gilead Healthcare Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Balm Of Gilead Healthcare Clinic LLC accept?

Health plans from HealthPartners and Sanford Health Plan list Balm Of Gilead Healthcare Clinic LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Balm Of Gilead Healthcare Clinic LLC was last updated on February 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.