Forest Family Care, Inc

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F2018 Issued in SC

Legal business name

FOREST FAMILY CARE, INC

Doing business as

Forest Family Care

Practice address

3874 Renee Dr Unit B
Myrtle Beach, SC 29579-4358

Phone

(843) 903-4500

Fax

(843) 903-4505

NPI assigned

Jul 9, 2011

Last updated

Mar 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Grace Smith Chasse, FNP-CNPI 1679094601

Title

Owner/Ceo

Phone

(843) 903-4500

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Forest Family Care Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Grace Smith Chasse, FNP-C

  • Family Nurse Practitioner
  • Myrtle Beach, SC
  • NPI 1679094601
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1310169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647907200000",
    "number": "1811284912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3874 RENEE DR UNIT B",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794358",
            "telephone_number": "843-997-2380",
            "fax_number": "843-903-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3874 RENEE DR UNIT B",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794358",
            "telephone_number": "843-903-4500",
            "fax_number": "843-903-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST FAMILY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-09",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A",
        "authorized_official_last_name": "SMITH CHASSE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "843-903-4500",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "F2018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID ID",
            "identifier": "NP5615",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5747",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Virginia M Forbes
• Ksenia Ford
• Michael Ford, M.D.
• Thomas Gardner Foreman, MD
• Forest Crossing Family Dental, LLC
• Forest Family Practice, LLC
• Kyle Allan Forman, DPT
• Kathy Lee Fortner, ED.S, LPC
• Jane Medlin Fortune, LPC
• Madelynn Laci Fougere

• Family Nurse Practitioner in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.