Organization Active NPI

Passmore Plastic Surgery LLC

  • Plastic Surgery Physician
  • Fort Smith, AR
National Provider Identifier
1164039475
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PASSMORE PLASTIC SURGERY LLC
Practice address
8101 McClure Dr Ste 100
Fort Smith, AR 72916-6044
Phone
(479) 242-2442
Fax
(479) 242-4220
NPI assigned
Sep 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Authorized official

Name
Ann K Passmore, MDNPI 1760400477
Title
Owner
Phone
(479) 242-2442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

8101 McClure Dr Ste 100
Fort Smith, AR 72916-6044

Mailing address

8101 McClure Dr Ste 100
Fort Smith, AR 72916-6044
Phone (479) 242-2442

Other identifiers 2

IdentifierTypeStateIssuer
100223460AMedicaidOK
131621001MedicaidAR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apassmore@passmoreplasticsurgery.emadirect.md Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201008000088 AR Part B Supplier - Clinic/Group Practice 9436578606 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Smith, AR

National Provider Directory

National Provider Directory

Locations

7805 Phoenix Ave
Fort Smith, AR 72903
Phone (479) 242-2442

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767052800000",
    "number": "1164039475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 MCCLURE DR STE 100",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729166044",
            "telephone_number": "479-242-2442",
            "fax_number": "479-242-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 MCCLURE DR STE 100",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729166044",
            "telephone_number": "479-242-2442",
            "fax_number": "479-242-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSMORE PLASTIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-30",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A",
        "authorized_official_last_name": "PASSMORE",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-242-2442",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100223460A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131621001",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apassmore@passmoreplasticsurgery.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8101 McClure Dr Ste 100",
            "city": "Fort Smith",
            "state": "AR",
            "country_code": "US",
            "postal_code": "729166044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.