Individual provider Active NPI

James Porter Passmore, DDS

  • General Practice Dentistry
  • Erie, PA
National Provider Identifier
1285790196
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS027646L Issued in PA
Practice address
4801 Peach St
Erie, PA 16509-2044
Phone
(814) 864-9231
Fax
(814) 864-6307
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS027646L PA Primary

Addresses

Primary practice location

4801 Peach St
Erie, PA 16509-2044

Mailing address

4801 Peach St
Erie, PA 16509-2044
Phone (814) 864-9231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150626000096 PA Order and Referring Only - DentistPractitioner - Dentist 3779894159

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285790196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092044",
            "telephone_number": "814-864-9231",
            "fax_number": "814-864-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092044",
            "telephone_number": "814-864-9231",
            "fax_number": "814-864-6307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSMORE",
        "first_name": "JAMES",
        "middle_name": "PORTER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS027646L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.