Kimberly Renee Formo, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH00034796 Issued in WA

Practice address

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

Phone

(425) 483-2320

Fax

(425) 424-3256

NPI assigned

Aug 8, 2007

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

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Formo Enterprises, Inc

  • Nutrition Chiropractor
  • Woodinville, WA
  • NPI 1275899460
  Medicare reassignment NPD Authorized official
• Chiropractic Care Center, Inc.

  • Chiropractor
  • Woodinville, WA
  • NPI 1386910123
  NPD (past)

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1336330877",
    "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": {
        "last_name": "FORMO",
        "first_name": "KIMBERLY",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan N. Flick, PH.D.
• Wendy Joann Forbes, LMP
• Caylin Jamie Ford, LMHCA
• Janet Martha Ford, MD
• Formo Enterprises, Inc
• Molly E Fors, LMP
• Azure Forte, LMHC, TEP
• Jordyn Franklin
• Rachel A Freund, MD
• Solveig Kristina Frivold, LMFT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.