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FORM MEDICAL
NPI 1831616390
Physical Medicine & Rehabilitation - Neuromuscular Medicine in Denver, CO

Active since August 25, 2017
1525 RALEIGH ST STE 220, DENVER, CO 80204(720) 370-9559 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Aug 25, 2017 (2 updates tracked since 2017).

About Form Medical NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FORM MEDICAL (NPI 1831616390) is a healthcare organization registered as a neuromuscular medicine in Denver, Colorado and active in the NPI registry since August 2017. The organization lists Jessica Kelner, Physician/manager, as its authorized official.

NPPES Registry Identity

NPI1831616390
Entity TypeOrganization
Primary Taxonomy2081N0008X
Legal Business NameFORM MEDICAL, PLLC
Location Address1525 RALEIGH ST STE 220Denver, CO 80204-1374
Mailing Address1525 Raleigh St Ste 220Denver, CO 80204-1374 · (720) 370-9559
Phone(720) 370-9559
Organization SubpartNo
Authorized OfficialJessica KelnerPhysician/manager · (720) 370-9559
Enumeration DateAugust 25, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1831616390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Neuromuscular MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2081N0008X
License✔ Licensed in CO · DR.0058123
Definition
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.
1525 RALEIGH ST STE 220, Denver, CO 80204
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Other Names 1

Doing Business AsForm Medical

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MAURICIO WAINTRUB M.D.P.C
Clinic/Center (Primary Care)
1525 RALEIGH ST STE 220
DENVER, CO 80204
Denver County (303) 433-2565

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Form Medical, PLLC's NPI number?

The NPI number for Form Medical, PLLC is 1831616390. It was assigned to this organization in the NPPES registry on August 25, 2017. The provider is doing business as Form Medical.

Where is Form Medical, PLLC located?

Form Medical, PLLC is located at 1525 Raleigh St Ste 220, Denver, CO 80204. The listed phone number is (720) 370-9559.

What is Form Medical, PLLC's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Neuromuscular Medicine, with taxonomy code 2081N0008X.

When was this NPI record last updated?

The NPPES record for Form Medical, PLLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.