Courtney Forman, PMHNP-BC, FNP-C, FPA
NPI 1376099127 · Nurse Practitioner · Rockford, IL
Provider details
- NPI number
- 1376099127
- Entity type
- Individual
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PMHNP-BC, FNP-C, FPA
- Sex
- Female
- Sole proprietor
- No
- License
- 277004073 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
9 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)25% of score
255 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Subsequent Nursing Facility Care With Moderate Level of Medical Decision Making, Per Day, If Using Time, at Least 30 Minutes99309 | 63 | $88 |
| Subsequent Nursing Facility Care With Straightforward Level of Medical Decision Making, Per Day, If Using Time, 20 Minutes Or More99308 | 59 | $61 |
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 35 | $100 |
| Subsequent Nursing Facility Care With Straightforward Level of Medical Decision Making, Per Day, If Using Time, at Least 10 Minutes99307 | 32 | $33 |
| Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, at Least 35 Minutes99232 | 31 | $69 |
| Initial Hospital Care With Straightforward Or Low-Level Medical Decision Making, If Using Time, at Least 55 Minutes |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$1,377 across 63 records (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Additional practice locations (1)
- 13508 Julie DrPoplar Grove, IL 61065-7829Phone: (815) 209-8486
Registry dates
- Enumerated
- 2016-08-31
- Last updated
- 2026-03-30
- Certified
- 2026-03-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.