MIDWEST MENTAL HEALTH CLINIC PLLC
NPI 1861877052
Nurse Practitioner - Psychiatric/Mental Health in Fargo, ND
About Midwest Mental Health Clinic Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MIDWEST MENTAL HEALTH CLINIC PLLC (NPI 1861877052) is a healthcare organization registered as a psychiatric/mental health in Fargo, North Dakota and active in the NPI registry since July 2015. The organization maintains 3 additional practice locations and lists Jacqualine Gervais, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 3
Group Practice 1
Accepted 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)
Midwest Mental Health Clinic Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
9Medicare enrollment records show 9 clinicians reassign Medicare billing to Midwest Mental Health Clinic PLLC, which bills Medicare for the services they deliver. Of these, 8 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (9)
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 Midwest Mental Health Clinic PLLC's NPI number?
The NPI number for Midwest Mental Health Clinic PLLC is 1861877052. It was assigned to this organization in the NPPES registry on July 29, 2015.
Where is Midwest Mental Health Clinic PLLC located?
Midwest Mental Health Clinic PLLC is located at 1122 1st Ave N, Fargo, ND 58102. The listed phone number is (218) 477-1353.
What is Midwest Mental Health Clinic PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Midwest Mental Health Clinic PLLC enrolled in Medicare?
Yes. Midwest Mental Health Clinic PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Midwest Mental Health Clinic PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 2 Medicare specialties reassign their Medicare billing to Midwest Mental Health Clinic PLLC. 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. The largest specialties are Nurse Practitioner (8) and Clinical Social Worker (1). Of these, 8 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Midwest Mental Health Clinic PLLC accept?
Health plans from Blue Cross Blue Shield of North Dakota, HealthPartners, Premera Blue Cross Blue Shield of Alaska and Sanford Health Plan list Midwest Mental Health Clinic PLLC 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 Midwest Mental Health Clinic PLLC was last updated on January 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.
# Midwest Mental Health Clinic Pllc · NPI 1861877052
Psychiatric/Mental Health organization in Fargo, North Dakota. Organization record, active in the CMS NPPES registry since July 29, 2015.
## Identity
- **NPI:** 1861877052 (Entity type: Organization)
- **Enumerated:** July 29, 2015
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Jacqualine Gervais, OWNER
## Practice location
- **Address:** 1122 1ST AVE N, Fargo, ND 58102-4604
- **Phone:** (218) 477-1353 · **Fax:** (218) 477-1354
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 9 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (8), Clinical Social Worker (1); 8 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 17, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1861877052) · Data from the CMS NPPES public registry.