NPIMap

Individual provider Active NPI

Kelsie Passmore

  • Physician Assistant
  • Fairview, MI
National Provider Identifier
1639660947
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1910 E Miller Rd
Fairview, MI 48621-8731
Phone
(989) 848-5644
NPI assigned
May 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1910 E Miller Rd
Fairview, MI 48621-8731

Mailing address

PO Box 427
Hillman, MI 49746-0427
Phone (989) 848-5644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180829004393 MI Practitioner - Physician Assistant 7719237411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wayne State University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Central MichiganGroup PAC ID 6103733092, 183 clinicians
Thunder Bay Community Health Service IncGroup PAC ID 0143296772, 39 clinicians

Practice addresses (Care Compare)

1221 S Dr
Mount Pleasant, MI 48858-3257
Phone (989) 772-6811

15774 State St
Hillman, MI 49746-7961
Phone (989) 742-4583

2110 S M
West Branch, MI 48661-8821

Hospital & facility affiliations

  • Mymichigan Medical Center West Branch Hospital, West Branch, MI, CCN 230095
  • McLaren Bay Region Hospital, Bay City, MI, CCN 230041
  • Munson Healthcare Grayling Hospital Hospital, Grayling, MI, CCN 230058
  • McLaren Central Michigan Hospital, Mount Pleasant, MI, CCN 230080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Central Michigan CurrentSince Aug 1, 2020 Accepting new patients
McLaren Central Michigan CurrentSince Aug 1, 2020 Accepting new patients
Thunder Bay Community Health Service, Inc CurrentSince Sep 22, 2025 Accepting new patients
Thunder Bay Community Health Service, Inc CurrentSince Sep 22, 2025 Accepting new patients
Thunder Bay Community Health Service, Inc Past Accepting new patients

Locations

11899 M 32
Atlanta, MI 49709
Phone (989) 785-4855

1910 E Miller Rd
Fairview, MI 48621
Phone (989) 848-5484

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

2110 S M 76
Ste 6
West Branch, MI 48661
Phone (989) 345-1184

Organizations & group practices 33

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 33

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1639660947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 427",
            "city": "HILLMAN",
            "state": "MI",
            "postal_code": "497460427",
            "telephone_number": "989-848-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 E MILLER RD",
            "city": "FAIRVIEW",
            "state": "MI",
            "postal_code": "486218731",
            "telephone_number": "989-848-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSMORE",
        "first_name": "KELSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview, MI

Sources for this page

Verify at the official NPI Registry.