Hazel Forman

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

License

FCL-041-082 Issued in NC

Practice address

1200 Moody St
Greensboro, NC 27401-4217

Phone

(336) 860-4060

Fax

(336) 937-9157

NPI assigned

Feb 4, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• HMF Family Care Homes

  • Adult Care Home Facility
  • Gibsonville, NC
  • NPI 1821714296
  NPD Authorized official
• L&H Agape Family Care Homes

  • Adult Care Home Facility
  • Greensboro, NC
  • NPI 1235721937
  NPD Authorized official
• L&H Agape Family Care Homes

  • Adult Care Home Facility
  • Greensboro, NC
  • NPI 1821682469
  NPD Authorized official

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1205428992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 MOODY ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274014217",
            "telephone_number": "336-709-6601",
            "fax_number": "336-937-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MOODY ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274014217",
            "telephone_number": "336-860-4060",
            "fax_number": "336-937-9157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "HAZEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-04",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "NC",
            "license": "FCL-041-081",
            "primary": false
        },
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "NC",
            "license": "FCL-041-082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Forester, SLP
• Forever Young Home Care
• Forge Counseling
• Nicole Forlan, WHNP-BC
• Caroline Elizabeth Forman, M.A., CCC-SLP
• Kristen Suzanne Forneris, M.S., NCC, LPCA
• Tara Forrest
• Cindy Kate Forrester, NP
• Daniel Forrester, PHARMD
• Misty Vandergriff Forsberg, BSN, RNC-OB

• Home Modifications Contractor in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Home Modifications Contractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.