Individual provider Active NPI

David Alan Forman, RPH

  • Pharmacist
  • Peabody, MA
National Provider Identifier
1528908670
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH15694 Issued in MA
Practice address
2 Johnson St
Peabody, MA 01960-2311
Phone
(978) 335-1204
Fax
(978) 535-0247
NPI assigned
Mar 30, 2026
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH15694 MA Primary
Pharmacist 183500000X PR5045 ME

Addresses

Primary practice location

2 Johnson St
Peabody, MA 01960-2311

Mailing address

2 Johnson St
Peabody, MA 01960-2311
Phone (978) 335-1204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH15694MAMDPharmacist
PR5045MEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1774828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1528908670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 JOHNSON ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602311",
            "telephone_number": "978-335-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 JOHNSON ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602311",
            "telephone_number": "978-335-1204",
            "fax_number": "978-535-0247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-03-30",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH15694",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR5045",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.