Merit FL Fondong, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4015 Issued in MN

Practice address

210 Gateway Dr NE Ste 1
East Grand Forks, MN 56721-1621

Phone

(218) 207-2020

Fax

(800) 582-1083

NPI assigned

Jul 29, 2015

Last updated

Feb 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, ND2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Balm of Gilead Healthcare Clinic LLCGroup PAC ID 0648635714, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: balmofgilead.muluh.fondong@157148.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Balm of Gilead Healthcare Clinic LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • East Grand Forks, MN
  • NPI 1154022895
  Medicare reassignment Care Compare group NPD Authorized official
• Carrington Health Center

  dba CHI St. Alexius Health Carrington Medical Clinic & Urgent Care

  • Rural Health Clinic/Center
  • Carrington, ND
  • NPI 1558389338
  Medicare reassignment NPD
• Mercy Hospital of Devils Lake

  dba CHI St Alexius Health Devils Lake

  • Emergency Medicine Physician
  • Devils Lake, ND
  • NPI 1790751170
  Medicare reassignment NPD
• Mahnomen Health Center

  • Rural Acute Care Hospital
  • Mahnomen, MN
  • NPI 1942233234
  Medicare reassignment
• Sanford Medical Center Fargo

  dba Sanford 1717 Medical Building

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924

  MN

  Medicare reassignment
• Spectra Health

  • Federally Qualified Health Center (FQHC)
  • Grand Forks, ND
  • NPI 1114343423
  Medicare reassignment
• Balm of Gilead Healthcare LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • East Grand Forks, MN
  • NPI 1730889882

  Family

  NPD
• Carrington Health Center

  dba Presentation Hospice

  • Critical Access Hospital
  • Carrington, ND
  • NPI 1598736019
  NPD
• Carrington Health Center

  dba CHI St. Alexius Health Carrington Family Clinic

  • Rural Health Clinic/Center
  • New Rockford, ND
  • NPI 1801811666
  NPD
• Mercy Hospital of Devils Lake

  dba CHI St Alexius Health Devils Lake Clinic

  • Clinic/Center
  • Devils Lake, ND
  • NPI 1184117293
  NPD

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1306221460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 GATEWAY DR NE STE 1",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211621",
            "telephone_number": "218-207-2020",
            "fax_number": "800-582-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 GATEWAY DR NE STE 1",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211621",
            "telephone_number": "218-207-2020",
            "fax_number": "800-582-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONDONG",
        "first_name": "MERIT",
        "middle_name": "FL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-29",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R219786-9",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "4015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Marie Ebertowski, PT
• Edgewood Vista
• Terra Nicole Edwards, APRN, PMHNP-BC
• Chelsea Erickson, D.D.S.
• Sarah Erickson, DPT
• Forks Optometric, LTD. (Opticare)
• Hannah Stephanie Fundaun, PHARMD
• Cathy A Galstad, MS CCC/SLP
• Steven Phillip Gander, O.D.
• Mridu Gandhi, MD

• Psychiatric/Mental Health Nurse Practitioner in East Grand Forks, MN
• Providers in East Grand Forks, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.