Individual provider Active NPI

Valentine Asongsang Forcha, FNP

  • Family Nurse Practitioner
  • Upper Arlington, OH
National Provider Identifier
1134531643
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F0514317 Issued in OH
Practice address
3924 Mountview Rd
Upper Arlington, OH 43220-4806
Phone
(614) 338-9158
Fax
(614) 569-2257
NPI assigned
Jun 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN-388201 OH
Family Nurse Practitioner 363LF0000X F0514317 OH Primary

Addresses

Primary practice location

3924 Mountview Rd
Upper Arlington, OH 43220-4806

Mailing address

PO Box 21351
Columbus, OH 43221-0351
Phone (614) 338-9158

Other identifiers 1

IdentifierTypeStateIssuer
0107643MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140828002387 OH Practitioner - Nurse Practitioner 2264650498 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN-388201OHMDRegistered Nurse
F0514317OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince May 30, 2023 Accepting new patients
Helping Hands Home Healthcare Agency LLC Current Accepting new patients
Reliance Health Clinic, LLP Current Accepting new patients

Locations

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

5320 E Main St
Ste 200
Whitehall, OH 43213
Phone (614) 804-6369

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1134531643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21351",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432210351",
            "telephone_number": "614-338-9158",
            "fax_number": "614-569-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3924 MOUNTVIEW RD",
            "city": "UPPER ARLINGTON",
            "state": "OH",
            "postal_code": "432204806",
            "telephone_number": "614-338-9158",
            "fax_number": "614-569-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORCHA",
        "first_name": "VALENTINE",
        "middle_name": "ASONGSANG",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-02",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN-388201",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "F0514317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0107643",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Arlington, OH

Sources for this page

Verify at the official NPI Registry.