FOREST FAMILY PRACTICE, LLC
NPI 1568585966
Nurse Practitioner - Family in Myrtle Beach, SC
NPI Status: Active since April 09, 2007
Contact Information
3874 RENEE DRIVE
SUITE B
MYRTLE BEACH, SC
ZIP 29579
Phone: (843) 903-4401
- Organization
- Nurse Practitioner
- Family
- CLIA Number: 42D1067277
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 04-15-2027
About FOREST FAMILY PRACTICE, LLC
This page provides the complete NPI Profile along with additional information for Forest Family Practice, Llc, a provider established in Myrtle Beach, South Carolina operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1568585966 assigned on April 2007. The practitioner's primary taxonomy code is 363LF0000X with license number F 2018 (SC). The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Miss Deborah Tully (Business Manager)
- NPI
- 1568585966
- Provider Name
- FOREST FAMILY PRACTICE, LLC
- Entity Type
- Organization
- Location Address
- 3874 RENEE DRIVE SUITE B MYRTLE BEACH, SC 29579
- Location Phone
- (843) 903-4401
- Mailing Address
- 3874 RENEE DRIVE SUITE B MYRTLE BEACH, SC 29579
- Mailing Phone
- (843) 903-4401
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-09-2007
- Last Update Date
- 08-22-2020
- Code Navigator
A nurse practitioner (NP) like Forest Family Practice, Llc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- F 2018
- License State
- SC
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 42D1067277
- Facility Type
- Practitioner Other
- Certificate Effective Date
- April 16, 2025
- Certificate Expiration Date
- April 15, 2027
- Laboratory Director
- JESSICA G. SMITH-CHASSE
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Forest Family Practice, Llc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1568585966, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1568585966, enumerated as an "organization" on April 09, 2007.
The provider is located at 3874 RENEE DRIVE SUITE B MYRTLE BEACH, SC 29579 and the phone number is (843) 903-4401.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
