NPIMap

Individual provider Active NPI

Casey Forman

  • Physician Assistant
  • Richmond, VA
National Provider Identifier
1750055307
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110008253 Issued in VA
Practice address
1501 Maple Ave Ste 206
Richmond, VA 23226-2553
Phone
(844) 893-0012
NPI assigned
Aug 6, 2021
Last updated
Feb 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110008253 VA Primary

Addresses

Primary practice location

1501 Maple Ave Ste 206
Richmond, VA 23226-2553

Mailing address

352 W Northfield Blvd Ste 3
Murfreesboro, TN 37129-1539
Phone (844) 893-0012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220325000043 VA Practitioner - Physician Assistant 6709271968 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mid West Medical College, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Twelvestone Infusion Centers LLCGroup PAC ID 6800151424, 64 clinicians
Richmond Gastroenterology Associates, Inc.Group PAC ID 8426950692, 39 clinicians

Practice addresses (Care Compare)

1501 Maple Ave
Suite 206
Richmond, VA 23226-2553
Phone (844) 893-0012

165 Wadsworth Dr
North Chesterfield, VA 23236-4500
Phone (804) 330-4901

169 Wadsworth Dr
North Chesterfield, VA 23236-4500
Phone (804) 330-4021

215 Wadsworth Dr
North Chesterfield, VA 23236-4510
Phone (804) 330-4021

223 Wadsworth Dr
North Chesterfield, VA 23236-4510
Phone (804) 330-4021

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110008253VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Twelvestone Infusion Centers LLC Single Specialty CurrentSince Jan 19, 2026 Accepting new patients
Infusion Solutions LLC Single Specialty Past Accepting new patients

Locations

1501 Maple Ave
Ste 206
Richmond, VA 23226

2965 Colonnade Dr
Fl 1
Roanoke, VA 24018

2965 Colonnade Dr
Ste 140
Roanoke, VA 24018
Phone (540) 400-8777

Organizations & group practices 3

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1750055307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 W NORTHFIELD BLVD STE 3",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291539",
            "telephone_number": "844-893-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MAPLE AVE STE 206",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262553",
            "telephone_number": "844-893-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "CASEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.