Kari Rose Formsma, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

4301059866 Issued in MI

Practice address

200 Jefferson Ave SE
9TH Floor
Grand Rapids, MI 49503-4502

Phone

(616) 685-6501

NPI assigned

Mar 21, 2006

Last updated

Jan 9, 2015By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pathway Womens Health PLC

  dba Formsma Kari R Sole MBR

  • Obstetrics & Gynecology Physician
  • Battle Creek, MI
  • NPI 1710009584
  NPD (past) Authorized official
• Carson City Center for Women's Healthcare PC

  • Obstetrics & Gynecology Physician
  • Carson City, MI
  • NPI 1396852976
  NPD (past)
• Sparrow Carson Hospital

  dba University of Michigan Health-Sparrow

  • Cardiovascular Disease Physician
  • Carson City, MI
  • NPI 1063245694
  NPD (past)

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1073572830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 44TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE",
            "address_2": "9TH FLOOR",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "616-685-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMSMA",
        "first_name": "KARI",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301059866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4764659",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Forgar
• Maggi Ann Forgue, D.O.
• Phedra L Forist, LPN
• Grace C Forlines
• John Michael Formolo, M.D.
• Kip Michael Forness, PSYD
• Camryn Fornwalt
• Arezu Leah Forouzandeh
• Shawn Forquer, LLMSW
• Alindia Forrest

• Obstetrics & Gynecology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.