Kerri Shea Forman, CST, A.S.

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

Practice address

7445 W. Washington Ave
302
Las Vegas, NV 89128

Phone

(281) 742-9544

NPI assigned

Aug 20, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Science

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1184390916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 RAINBOW RD",
            "city": "CHEPACHET",
            "state": "RI",
            "postal_code": "028144456",
            "telephone_number": "401-486-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7445 W. WASHINGTON AVE",
            "address_2": "302",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89128",
            "telephone_number": "281-742-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "KERRI",
        "middle_name": "SHEA",
        "name_prefix": "Ms.",
        "credential": "CST, A.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-08-20",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forge Ahead LLC
• Donovan Foriest
• Edward Henry Forkos II, MD
• Forma Integrated Healthcare
• Arjinae Forman
• Abby Formica
• Agatha Matsos Formoso, MD
• Miriam Formoso
• Ciana Fornaris
• Jasmina Santos Fornbacher, APRN

• Electroneurodiagnostic Specialist/Technologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Electroneurodiagnostic Specialist/Technologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.