Charles Forman

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1670 Upham Dr
Columbus, OH 43210-1250

Phone

(614) 293-4540

NPI assigned

Apr 17, 2014

Sex

Male

Sole proprietor

No

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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cforman20827@mhas.direct-ci.com

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.

• State of Ohio Office of Budget and Management State Accounting

  • Psychiatric Hospital
  • Cincinnati, OH
  • NPI 1023082716
  Medicare reassignment NPD
• State of Ohio Office of Budget and Management State Accounting

  • Psychiatric Hospital
  • Columbus, OH
  • NPI 1710951835
  NPD
• State of Ohio Office of Budget and Management State Accounting

  • Nursing Facility/Intermediate Care Facility
  • Sandusky, OH
  • NPI 1790732576
  NPD

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1194145011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 UPHAM DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101250",
            "telephone_number": "614-406-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 UPHAM DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101250",
            "telephone_number": "614-293-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-17",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Foresi
• Forestways OT LLC
• Forever Care LLC
• Dixon Alfred Fayiah Forleh
• Form and Function Healthcare LLC
• Heather R Forman, DPT
• Kelly Ann Forman, LSW
• Michael A Forman, PHD
• Nancy Walker Forman, PHD
• Patricia R Forman, M.D.

• Student in an Organized Health Care Education/Training Program in Columbus, OH
• Providers in Columbus, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.