Selene R Forrestall, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

22437 Issued in SC

Practice address

805 Pamplico Hwy
Florence, SC 29505-6047

Phone

(843) 792-1414

NPI assigned

Dec 13, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Selene R Forrestall Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA, SC, NC3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Massachusetts Anesthesiology Associates PCGroup PAC ID 9931348232, 5 clinicians

Mass General Brigham Medical Group, Inc.Group PAC ID 3971987108, 140 clinicians

Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Musc Medical Center Hospital, Charleston, SC, CCN 420004
• North Shore Medical Center - Hospital, Salem, MA, CCN 220035

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Musc Community Physicians

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006
  Medicare reassignment Care Compare group NPD
• Mass General Brigham Medical Group, Inc.

  • Internal Medicine Physician
  • Salem, NH
  • NPI 1083360200

  MA

  Medicare reassignment Care Compare group NPD
• Massachusetts Anesthesiology Associates, P.C.

  • Anesthesiology Physician
  • New Rochelle, NY
  • NPI 1902148760

  MA

  Medicare reassignment Care Compare group
• Ad of South Carolina LLC

  • Anesthesiology Physician
  • Charleston, SC
  • NPI 1205518792
  Medicare reassignment NPD
• Anesthesia Associates of Charleston, P.a.

  • Anesthesiology Physician
  • Charleston, SC
  • NPI 1396776670
  Medicare reassignment NPD
• Bon Secours St Francis Xavier Hospital, Inc.

  • Cardiovascular Disease Physician
  • Charleston, SC
  • NPI 1740502822
  Medicare reassignment NPD
• Hampton Regional Medical Center

  • Rural Acute Care Hospital
  • Varnville, SC
  • NPI 1487651949
  Medicare reassignment NPD
• McLeod Medical Center-Dillon

  • Hospitalist Physician
  • Dillon, SC
  • NPI 1720033988

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• North Charleston Sedation Associates, LLC

  • Certified Registered Nurse Anesthetist
  • Summerville, SC
  • NPI 1255185971

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1649726738
  Medicare reassignment NPD
• Concordia Anesthesiology, Inc

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1619296464

  SC

  Medicare reassignment NPD
• Firsthealth of the Carolinas, Inc

  • Certified Registered Nurse Anesthetist
  • Troy, NC
  • NPI 1053482596

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

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

• Medical University Hospital Authority

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1073605879
  Care Compare affiliation
• Medical University Hospital Authority

  • Rehabilitation Hospital
  • Orangeburg, SC
  • NPI 1154020147
  Care Compare affiliation
• Medical University Hospital Authority

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1659435840
  Care Compare affiliation
• Medical University Hospital Authority

  • Psychiatric Hospital
  • Orangeburg, SC
  • NPI 1669171740
  Care Compare affiliation
• Medical University Hospital Authority

  • General Acute Care Hospital
  • Orangeburg, SC
  • NPI 1710683354
  Care Compare affiliation
• Medical University Hospital Authority

  • General Acute Care Hospital
  • Orangeburg, SC
  • NPI 1770280299
  Care Compare affiliation
• North Shore Medical Center, Inc.

  • General Acute Care Hospital
  • Salem, MA
  • NPI 1730121633
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1013078013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23321",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873321",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 PAMPLICO HWY",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056047",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "690 Canton St",
            "address_2": "Suite 325",
            "address_purpose": "LOCATION",
            "city": "Westwood",
            "state": "MA",
            "postal_code": "020902321",
            "country_code": "US",
            "telephone_number": "781-407-7713",
            "fax_number": "781-407-0998",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "690 Canton St",
            "address_2": "Suite 325",
            "address_purpose": "LOCATION",
            "city": "Westwood",
            "state": "MA",
            "postal_code": "020902321",
            "country_code": "US",
            "telephone_number": "781-407-7713",
            "fax_number": "781-407-0998",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Doughty St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294035736",
            "country_code": "US",
            "telephone_number": "843-792-1414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9263 Medical Plaza Dr Ste E",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "29406",
            "country_code": "US",
            "telephone_number": "843-572-1228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054210",
            "country_code": "US",
            "telephone_number": "864-455-3076",
            "fax_number": "864-455-4135",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7 Independence Pt Ste 300",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296154569",
            "country_code": "US",
            "telephone_number": "864-522-3700",
            "fax_number": "864-522-3705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORRESTALL",
        "first_name": "SELENE",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "254742",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "22437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN2850",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "805 Pamplico Hwy",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295056047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SELENE",
            "last_name": "FORRESTALL",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cynthia Veronica Ford
• Eugenia M Ford, PT
• Katie Marie Ehlers Ford, OTR/L
• Nakima Geneva Ford
• Regina C Ford
• Allison Nelson Foster, MD
• Donna Foster
• Jessica Ryanne Foster
• Gary Fowler
• Michael Brandon Fowler

• Certified Registered Nurse Anesthetist in Florence, SC
• Providers in Florence, SC by specialty
• Certified Registered Nurse Anesthetist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.