Kyle Allan Forman, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12210 Issued in SC

Practice address

2200 Crow LN
Myrtle Beach, SC 29577-1663

Phone

(843) 848-5220

NPI assigned

Feb 6, 2024

Last updated

Feb 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgetown Physician Associates, LLCGroup PAC ID 2365697398, 221 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Georgetown Physician Associates, LLC

  dba Tidelands Health Family Medicine

  • Family Medicine Physician
  • Murrells Inlet, SC
  • NPI 1235475930
  Medicare reassignment Care Compare group NPD
• Georgetown Physician Associates LLC

  dba Tidelands Health Group

  • Family Medicine Physician
  • Georgetown, SC
  • NPI 1881410587
  NPD
• Georgetown Physician Associates, LLC

  dba Tidelands Health Rehabilitation Services

  • Physical Therapy Clinic/Center
  • Myrtle Beach, SC
  • NPI 1124673793
  NPD

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

{
    "created_epoch": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1912760463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 STILL WOOD TRL",
            "city": "FOUNTAIN INN",
            "state": "SC",
            "postal_code": "296449276",
            "telephone_number": "407-462-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 CROW LN",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295771663",
            "telephone_number": "843-848-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "KYLE",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Ford, M.D.
• Thomas Gardner Foreman, MD
• Forest Crossing Family Dental, LLC
• Forest Family Care, Inc (Forest Family Care)
• Forest Family Practice, LLC
• Kathy Lee Fortner, ED.S, LPC
• Jane Medlin Fortune, LPC
• Madelynn Laci Fougere
• Tasha Foushee, M.D.
• Lionel Thomas Fowler, DMD

• Physical Therapist in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.