FORM MEDICAL – NPI #1831616390
Physical Medicine & Rehabilitation

A physician who specializes in neuromuscular medicine possesses specialized knowledge in the science, clinical evaluation and management of these disorders. This encompasses the knowledge of the pathology, diagnosis and treatment of these disorders at a level that is significantly beyond the training and knowledge expected of a general neurologist, child neurologist or physiatrist.

FORM MEDICAL is a provider located in DENVER, CO. NPPES has assigned the NPI number 1831616390 to FORM MEDICAL on August 25, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “FORM MEDICAL” is a dba name, the actual legal business name for this organization is FORM MEDICAL, PLLC. The primary taxonomy selected by this provider is 2081N0008X from the Health Care Provider Taxonomy code set, which is classified as Physical Medicine & Rehabilitation, specializing in Neuromuscular Medicine

The NPI profile was previously updated about 4 years ago on Jul 21, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for FORM MEDICAL below.

NPI Profile for
FORM MEDICAL, PLLC

NPI Number
1831616390
Enumeration Date

(about 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
FORM MEDICAL, PLLC
Doing Business As (dba): FORM MEDICAL
Primary location
1525 RALEIGH ST STE 220
DENVER, CO 80204-1374
Phone: (720) 370-9559 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JESSICA KELNER
PHYSICIAN/MANAGER
Phone: (720) 370-9559
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2081N0008X
- Physical Medicine & Rehabilitation / Neuromuscular Medicine (Primary)
CO DR.0058123

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.