Formo Enterprises, Inc

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

CH00034796 Issued in WA

Legal business name

FORMO ENTERPRISES, INC

Practice address

17401 135TH Ave NE
Suite #4
Woodinville, WA 98072-6825

Phone

(425) 483-2320

Fax

(425) 424-3256

NPI assigned

Apr 2, 2012

Organization subpart

Yes

Parent organization

KIMBERLY FORMO, DCAs reported in NPPES

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

Authorized official

Name

Kimberly Renee Formo, D.C.NPI 1336330877

Title

President/Chiropractor

Phone

(425) 483-2320

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Renee Formo, D.C.

  • Chiropractor
  • Woodinville, WA
  • NPI 1336330877
  Medicare reassignment NPD Authorized official
• Allen Gordon Green, DC

  • Chiropractor
  • Woodinville, WA
  • NPI 1669415956
  NPD (past)
• Lise Mary Peterson, LMP

  • Specialist
  • Woodinville, WA
  • NPI 1073644969
  NPD (past)
• Robin Marie Western, LMP

  • Specialist
  • Woodinville, WA
  • NPI 1780863548
  NPD (past)

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1275899460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17401 135TH AVE NE",
            "address_2": "SUITE #4",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980726825",
            "telephone_number": "425-483-2320",
            "fax_number": "425-424-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17401 135TH AVE NE",
            "address_2": "SUITE #4",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980726825",
            "telephone_number": "425-483-2320",
            "fax_number": "425-424-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORMO ENTERPRISES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KIMBERLY FORMO, DC",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "FORMO",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PRESIDENT/CHIROPRACTOR",
        "authorized_official_telephone_number": "425-483-2320",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "WA",
            "license": "CH00034796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bella Fleur, LMP
• Susan N. Flick, PH.D.
• Wendy Joann Forbes, LMP
• Caylin Jamie Ford, LMHCA
• Janet Martha Ford, MD
• Kimberly Renee Formo, D.C.
• Molly E Fors, LMP
• Azure Forte, LMHC, TEP
• Jordyn Franklin
• Rachel A Freund, MD

• Nutrition Chiropractor in Woodinville, WA
• Providers in Woodinville, WA by specialty
• Nutrition Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.