Davita Paula Forman, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-07617 Issued in NC

Practice address

4220 Apex Hwy Ste 200
Durham, NC 27713-5295

Phone

(855) 501-1004

NPI assigned

Aug 25, 2017

Last updated

May 14, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mindpath Care Centers North Carolina PLLCGroup PAC ID 4688655517, 115 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: forman.davita.001.0330220@cpic.meditab.direct-ci.com
• Direct secure messaging: mpnc.davitaforman@114018.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindpath Care Centers, North Carolina, PLLC

  dba Mindpath Health, a practice of, MindPath Care Centers, North Carolina,

  • Psychiatry Physician
  • Durham, NC
  • NPI 1508803214
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1538686068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 APEX HWY STE 200",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277135295",
            "telephone_number": "855-501-1004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 Creekshire Way",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033059",
            "country_code": "US",
            "telephone_number": "336-701-3111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "DAVITA",
        "middle_name": "PAULA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-07617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John William Foreman, M.D.
• Forest Hills Adult Care
• Holly Forester-Miller, PHD
• Sarah Forester
• Erin Forfa, PT, DPT
• Leslie M Forman I, M.D.
• Lauren Alexis Formy-Duval, PSY.D.
• Christopher Robert Forrest, MD, FRCSC, FACS, FRA
• Michael Tcheupdjian Forrester, MD, PHD
• Ann Forsthoefel, FNP

• Medical Physician Assistant in Durham, NC
• Providers in Durham, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.