Active NPI
Carolyn Jean Forman, O.M.D.
- Acupuncturist
- Charles Town, WV
National Provider Identifier
1831383728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 96196
- Practice address
- 64 Somerset Blvd
Charles Town, WV 25414-4827 - Phone
- (304) 728-5066
- Fax
- (304) 728-5074
- NPI assigned
- Sep 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 96196 | WV | Primary |
Addresses
Primary practice location
64 Somerset Blvd
Charles Town, WV 25414-4827
Mailing address
110 Brookland CT Apt 12
Winchester, VA 22602-6181
Phone (540) 550-0306
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 96196 | WV | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capitol Rehab | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Charles Town, WV
- NPI 1245309798
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188864000000",
"number": "1831383728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 BROOKLAND CT APT 12",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "226026181",
"telephone_number": "540-550-0306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 SOMERSET BLVD",
"city": "CHARLES TOWN",
"state": "WV",
"postal_code": "254144827",
"telephone_number": "304-728-5066",
"fax_number": "304-728-5074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORMAN",
"first_name": "CAROLYN",
"middle_name": "JEAN",
"credential": "O.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-04",
"last_updated": "2007-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "WV",
"license": "96196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charles Town, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.