Christopher C Formen, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

2006009448 Issued in MO

Practice address

2800 Clay Edwards Dr
Kansas City, MO 64116-3220

Phone

(816) 691-5201

NPI assigned

Aug 11, 2006

Sex

Male

Sole proprietor

No

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.

• Northland Radiology, Inc.

  • Diagnostic Radiology Physician
  • Kansas City, MO
  • NPI 1679518260

  Diagnostic Radiology, KS, MO

  Medicare reassignment Care Compare group NPD
• North Kansas City Hospital

  • Community/Retail Pharmacy
  • North Kansas City, MO
  • NPI 1003381948
  NPD (past)

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

• Excelsior Springs City Hospital

  • Critical Access Hospital
  • Excelsior Springs, MO
  • NPI 1609870310

  Hospital

  Care Compare affiliation
• New Liberty Hospital Corporation

  • General Acute Care Hospital
  • Liberty, MO
  • NPI 1548001464

  Hospital

  Care Compare affiliation
• North Kansas City Hospital

  • Skilled Nursing Facility
  • North Kansas City, MO
  • NPI 1437103215

  Hospital

  Care Compare affiliation
• North Kansas City Hospital

  • General Acute Care Hospital
  • North Kansas City, MO
  • NPI 1629062799

  Hospital

  Care Compare affiliation
• Ray County Memorial Hospital

  • Critical Access Hospital
  • Richmond, MO
  • NPI 1245220052

  Hospital

  Care Compare affiliation
• University of Kansas Hospital Authority

  • General Acute Care Hospital
  • Kansas City, KS
  • NPI 1629369681

  Hospital

  Care Compare affiliation
• University of Kansas Hospital Authority

  • General Acute Care Hospital
  • Kansas City, KS
  • NPI 1649259656

  Hospital

  Care Compare affiliation

Specialty

Diagnostic Radiology

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northland Radiology Inc 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• NKC Health Hospital, North Kansas City, MO, CCN 260096
• Liberty Hospital Hospital, Liberty, MO, CCN 260177
• University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040
• Excelsior Springs Hospital Hospital, Excelsior Springs, MO, CCN 261322
• Ray County Memorial Hospital Hospital, Richmond, MO, CCN 261327

Medicare fee-for-service enrollment

Enrolled in MO, KS2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/MtxVU3dbzZwHcvfCb2vTAE2_Nwhai9Oq/

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 6, 2011.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1922019942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419380 - DEPT 128",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641416380",
            "telephone_number": "913-642-4900",
            "fax_number": "913-381-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CLAY EDWARDS DR",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641163220",
            "telephone_number": "816-691-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMEN",
        "first_name": "CHRISTOPHER",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2006009448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7406930",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922019942",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200666250A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00355712",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC",
            "identifier": "37226019",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Forge
• Donna Marie Forgey, PH.D.
• Alan D. Forker, MD
• Justin Forkpa
• John M Forman, MD
• Mirae Fornander
• Rebecca Lynn Forrest, MS, RD, LD
• Denise Forrester, RN
• Daniel Forsha
• Jameson Forster, MD

• All providers in Kansas City, MO
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.