Courtney Nicolle Forman, PMHNP-BC, FNP-C, FPA
Nurse Practitioner · Rockford, IL
Courtney Nicolle Forman, PMHNP-BC, FNP-C, FPA is a nurse practitioner with a practice address in Rockford, Illinois, and NPI 1376099127, issued on Aug 31, 2016. Check the license (Illinois 227.004073, as entered in NPPES) with the Illinois board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Courtney Nicolle Forman
- Credential
- PMHNP-BC, FNP-C, FPA
- Primary taxonomy
- Nurse Practitioner 363L00000X
- License numbers
- 227.004073 IL
209014910 IL
277004073 IL
Self-reported in NPPES; status is on the state search - Practice location
- 2823 Glenwood Ave, Rockford, IL 61101
- Phone
- (815) 968-5342
- Enumerated
- Aug 31, 2016
- Record last updated
- Mar 30, 2026
- Fax
- (815) 968-4656
- Medicare enrollment
- Enrolled (PECOS I20161003001862); accepts Medicare assignment
- Medical or professional school
- Indiana University School Of Medicine, 2011
- Entity
- Type 1 · individual
8 nearest nurse practitioner records → All 4,892 in Illinois → Look up another NPI →
Also registered at 2823 Glenwood Ave
A shared address usually means a shared clinic or building; it does not show who employs whom.
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- Frank Cushing, ED.D.Clinical Psychologist1013055144
- Kyle Cushing, PSY.D.Clinical Psychologist1346259157
- Carol Fisher, LCSWClinical Social Worker1346376753
- Dana Kiley, LCSWClinical Social Worker1033208871
Verify Courtney Nicolle Forman in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Illinois board licenses this profession
Search for license 227.004073Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
15% fewer Medicare Part D claims than the average nurse practitioner in 2024
942 Medicare Part D claims for 101 beneficiaries, against an average of 1,109 among the 54,319 providers of this specialty who prescribed in Part D. Brand-name drugs were 13% of claims.
Most prescribed
- Duloxetine Hcl101 claims
- Trazodone Hcl73 claims
- Venlafaxine Hcl Er68 claims
- Donepezil Hcl54 claims
- Rexulti54 claims
- Vraylar42 claims
Source: CMS Medicare Part D Prescribers by Provider and Drug, 2024 (data.cms.gov). Part D covers prescriptions for Medicare patients only; drugs with fewer than 11 claims are not published.
The practice group's MIPS final score for 2023 (Medicare payment program): 52.4 of 100
The Merit-based Incentive Payment System score is reported for the practice group, not for one clinician alone. Four categories are weighted into the final score; the average among 454,083 clinicians with a measured score was 83.5.
Source: CMS Quality Payment Program, MIPS performance year 2023, group reporting; category weights for 2023 (qpp.cms.gov).
Industry payments in 2024: $1,376.70
63 payments; by number, the most common kind was food and beverage; the largest payer was Otsuka America Pharmaceutical, Inc. The 38,884 providers of this specialty with any payment received $791.64 on average. Payments are reported by manufacturers, not by the provider, and are not a sign of wrongdoing.
Source: CMS Open Payments, program year 2024 (openpaymentsdata.cms.gov); average among providers of this specialty with at least one payment.
Bills Medicare through one group practice
- Thrive Mental Wellness, PLLCPoplar Grove, IL
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
Courtney Nicolle Forman among 4,892 nurse practitioner records in Illinois
Courtney Nicolle Forman, PMHNP-BC, FNP-C, FPA is one of 4,892 nurse practitioner records with a practice address in Illinois. 81% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2016, is newer than 36% of them.
- NPI issued2016 · 36% of these records are older, 58% newer
- In a Medicare fileYes · 81% of these records are
- In the CMS Doctors and Clinicians fileYes · 69% of these records are
- Graduated2011 · median 2018 among the 3,389 with a school on file
- Record last updated2026 · 36% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 363L00000X and a Illinois practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
129 nurse practitioner records list a practice address in Rockford
They are 129 of the 3,893 NPPES records with a practice address in Rockford, and 4,892 nurse practitioner records in Illinois.
All 4,892 in Illinois → Every provider in Rockford → Nurse Practitioner nationwide →
The 8 nurse practitioner records with the nearest ZIP codes
- Colette Carter, APRNRockford, IL 611021164812541
- Rose Eggers, APNRockford, IL 611021689609372
- Sylvia Garza, APN-BCRockford, IL 611021588800700
- McKenzie Hogan-Stephens, DNP, APRN, FNP-BCRockford, IL 611021073445557
- Monica Lynch, APNRockford, IL 611021295779171
- Jessica Oslund, N.P.Rockford, IL 611021043791445
- Heather Hartman, CNPRockford, IL 611031598878464
- Lisa Larson, APRNRockford, IL 611031770643397
Common questions
What is Courtney Nicolle Forman, PMHNP-BC, FNP-C, FPA's NPI number?
Courtney Nicolle Forman, PMHNP-BC, FNP-C, FPA's National Provider Identifier (NPI) is 1376099127, issued on Aug 31, 2016. An NPI identifies a provider in billing; it is not a license.
Where is Courtney Nicolle Forman, PMHNP-BC, FNP-C, FPA located?
The NPPES record lists a practice address at 2823 Glenwood Ave, Rockford, IL, 61101. Phone: (815) 968-5342. Providers update this record themselves, so call before visiting.
How can I verify Courtney Nicolle Forman, PMHNP-BC, FNP-C, FPA's license?
NPPES lists Illinois license number 227.004073, as entered by the provider. Search the Illinois board that licenses this profession; the NPPES record confirms identity only.
How much does Courtney Nicolle Forman, PMHNP-BC, FNP-C, FPA prescribe under Medicare Part D?
In 2024, Courtney Nicolle Forman, PMHNP-BC, FNP-C, FPA had 942 Medicare Part D claims for 101 beneficiaries; the average among nurse practitioner prescribers was 1,109. Part D covers Medicare prescriptions only.
What is Courtney Nicolle Forman, PMHNP-BC, FNP-C, FPA's MIPS final score?
The 2023 MIPS final score is 52.4 of 100, reported for the practice group. The average among 454,083 clinicians with a measured score was 83.5.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.