Gina Suzanne Ballard-Schmunk, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Bemidji, MN
NPI 1346930591 · NPPES record last updated May 10, 2023
Key facts
- NPI
- 1346930591
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 10226 (MN)
- Practice address
- 1526 30TH St NW
Bemidji, MN 56601-4140 - Phone
- (218) 751-0887
- NPI assigned
- May 10, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1526 30TH St NW
Bemidji, MN 56601-4140
Phone (218) 751-0887
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240314001487 | MN | Practitioner - Nurse Practitioner | 8325484132 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10226 | MN | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Calm Minds Mental Health Services LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| Lifecare Medical Center | Current | Accepting new patients |
Locations
1526 30th St NW
Bemidji, MN 56601
Phone (218) 751-0887
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 10226 | MN | Yes |
Addresses
Primary practice location
1526 30TH St NW
Bemidji, MN 56601-4140
Mailing address
1526 30TH St NW
Bemidji, MN 56601-4140
Phone (218) 751-0887
Other providers in Bemidji, MN
- Sarah Lee Baker
- Jonetta H Bakke
- Hilton J Bakker
- Balanced Counseling and Consulting PLLC
- Taci Ball
- Roxanne Faye Banks
- Emily Celeste Barbot
- Emmalee Elaine Bardwell
- Ronald W. Bardwell
- Melissa Barrus
All providers in Bemidji, MN · Psychiatric/Mental Health Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.