NPIMap

Organization Active NPI

Ballem Harmony LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bryan, TX
National Provider Identifier
1124844469
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BALLEM HARMONY LLC
Practice address
4500 Carter Creek Pkwy Ste 101
Bryan, TX 77802-4464
Phone
(210) 367-1530
NPI assigned
Dec 3, 2024
Last updated
Feb 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Clarisa Che Minang
Title
Owner
Phone
(210) 367-1530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

4500 Carter Creek Pkwy Ste 101
Bryan, TX 77802-4464

Mailing address

4500 Carter Creek Pkwy Ste 101
Bryan, TX 77802-4464
Phone (210) 367-1530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241219004187 TX Part B Supplier - Clinic/Group Practice 9638606213 Receives reassigned benefits from 7 practitioners
Practice locations: Bryan, TX

National Provider Directory

National Provider Directory

Locations

4500 Carter Creek Pkwy
Ste 101
Bryan, TX 77802
Phone (210) 367-1530

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1124844469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 CARTER CREEK PKWY STE 101",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778024464",
            "telephone_number": "210-367-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 CARTER CREEK PKWY STE 101",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778024464",
            "telephone_number": "210-367-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALLEM HARMONY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-03",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A",
        "authorized_official_last_name": "MINANG",
        "authorized_official_first_name": "CLARISA",
        "authorized_official_middle_name": "CHE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-367-1530"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.