Jo Ann Formby, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

15634 Issued in TX

Practice address

11999 Katy Fwy
Suite 490
Houston, TX 77079-1611

Phone

(713) 365-0700

Fax

(713) 827-1080

NPI assigned

Jul 21, 2006

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: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Doctor on Demand Professionals P C

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1174931448
  NPD
• Renewing Hope Counseling, LLC

  • Mental Health Counselor
  • Houston, TX
  • NPI 1700110871
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1154342855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11999 KATY FWY",
            "address_2": "SUITE 490",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770791611",
            "telephone_number": "713-365-0700",
            "fax_number": "713-827-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11999 KATY FWY",
            "address_2": "SUITE 490",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770791611",
            "telephone_number": "713-365-0700",
            "fax_number": "713-827-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMBY",
        "first_name": "JO ANN",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "15634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TX",
            "identifier": "87140A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachelle Forges
• John R Foringer, M.D.
• Jacob Ellis Forker, LAT, ATC
• Karen Kay-Ann Forknot, R.N.
• Arthur D. Forman, M.D.
• Peter Formusoh
• Bruno D. Fornage, M.D.
• Louis Bruno Fornage, MD
• Anna Fornaris, LCDC, ADC
• Alexandria Marie Fornerette, PA-C

• Clinical Psychologist in Houston, TX
• Providers in Houston, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.