Fort Smith Ambulatory Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

FORT SMITH AMBULATORY SURGERY CENTER, LLC

Practice address

8306 Massard Creek CT
Fort Smith, AR 72903-6084

Phone

(844) 215-0731

NPI assigned

Jul 31, 2023

Organization subpart

No

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

Authorized official

Name

Elizabeth Waddell

Title

Executive Director of Surgical Serv

Phone

(501) 766-1065

Specialties & licenses 1

Addresses

Other names 1

• Fort Smith Ambulatory Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Ambulatory surgical center certification: CCN 04C0001122

Legal name

Fort Smith Ambulatory Surgery Center LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Nov 8, 2024

Last certification

Oct 22, 2024

Ownership / control type

Proprietary

Facility address

8306 Massard Creek Court
Fort Smith, AR 72903

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 2

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

• Amir Amidi, MD

  • Pain Clinic/Center
  • Fort Smith, AR
  • NPI 1306475470
  NPD (past)
• Meraj Siddiqui, MD

  • Interventional Pain Medicine Physician
  • Batesville, AR
  • NPI 1114973922
  NPD (past)

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1376224352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N SHACKLEFORD RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722112840",
            "telephone_number": "844-215-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8306 MASSARD CREEK CT",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729036084",
            "telephone_number": "844-215-0731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT SMITH AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A",
        "authorized_official_last_name": "WADDELL",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF SURGICAL SERV",
        "authorized_official_telephone_number": "501-766-1065"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Smith Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fort Smith Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gregory Oatis Fluitt, APN
• Mandy Lee Fluitt, APRN
• Tabitha Fondren
• Fort Health Partners PLLC
• Fort Neuro
• Fort Smith Behavioral Health Inc
• Fort Smith Cataract & Laser Center LLC
• Fort Smith Children'S Emergency Shelter, Inc.
• Fort Smith Dialysis Supply Company
• Fort Smith Emergency Hospital, LLC

• Ambulatory Surgical Clinic/Center in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Ambulatory Surgical Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.