Borealis Health PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BOREALIS HEALTH PLLC

Practice address

813 S Pokegama Ave Ste a
Grand Rapids, MN 55744-3934

Phone

(218) 297-1900

NPI assigned

Apr 10, 2025

Last updated

Apr 14, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennie Jon BataNPI 1255506929

Title

Owner

Phone

(218) 297-1900

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

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.

• Jennie Jon Bata, APRN/DNP/PMHNP/FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Grand Rapids, MN
  • NPI 1255506929

  Family

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1744243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1184419228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 S POKEGAMA AVE STE A",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443934",
            "telephone_number": "218-297-1900",
            "fax_number": "218-203-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 S POKEGAMA AVE STE A",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443934",
            "telephone_number": "218-297-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOREALIS HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-10",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A",
        "authorized_official_last_name": "BATA",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-297-1900"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184419228",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://jennie-bata.clientsecure.me/",
            "affiliation": "Y",
            "endpointDescription": "Used for secure patient and provider communication via practice portal.",
            "affiliationName": "SimplePractice",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Used for secure patient and provider communication via practice portal.",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Unspecified",
            "address_1": "813 S Pokegama Ave",
            "address_2": "Lower Level",
            "city": "Grand Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "557443934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Fredrick Bruce Blaisdell, MD
• Katrina Marie Boden, CNP
• Bonham Psychotherapy Services
• Bonner Eye Clinic Optical LLC
• Timothy Charles Bonner, M.D.
• Rachel Marie Bougalis, LPCC
• Emily Kathryn Bounds, OTR
• Lisa Ann Brandt, RPH
• Michael Allen Brandt, RPH
• Kate E Braun, M.A. P.T.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; 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.