Michael a Forman PHD Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2928 Issued in OH

Legal business name

MICHAEL A FORMAN PHD INC

Practice address

3545 Olentangy River Road
Suite 214
Columbus, OH 43214-3907

Phone

(614) 263-5908

Fax

(614) 263-5941

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael A Forman, PHDNPI 1194726133

Title

President

Phone

(614) 263-5908

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 2

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

• Michael A Forman, PHD

  • Psychologist
  • Columbus, OH
  • NPI 1194726133
  Medicare reassignment NPD Authorized official
• Nancy Walker Forman, PHD

  • Psychologist
  • Columbus, OH
  • NPI 1861484172
  Medicare reassignment NPD

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1508923137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 OLENTANGY RIVER RD",
            "address_2": "SUITE 214",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143907",
            "telephone_number": "614-263-5908",
            "fax_number": "614-263-5941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 OLENTANGY RIVER ROAD",
            "address_2": "SUITE 214",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143907",
            "telephone_number": "614-263-5908",
            "fax_number": "614-263-5941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL A FORMAN PHD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "FORMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-263-5908",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "OH",
            "license": "2928",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "OH",
            "license": "4417",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miami Valley Professional Services, LLC
• Maryam S Mian, MD
• Miaprep Online Academy of Ohio
• Megan Christine Miazga, PT, DPT
• Jirom H Micael
• Michael and Sons Transportation LLC
• Michael C Soult DMD & Albert H Hackman III, Inc.
• Michael D Conaway MD LLC
• Michael D. Bobb, Jr., DO, LLC
• Michael G. Saribalas D.O.

• Psychologist in Columbus, OH
• Providers in Columbus, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.