PASSPORT HEALTH HOLDINGS, LLC (NPI# 1467878595) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467878595 |
| Entity Type | Organization |
| Organization Name | PASSPORT HEALTH HOLDINGS, LLC |
| Other Organization Name | PASSPORT HEALTH |
| Practice Address |
8766 S Maryland Pkwy Suite 104 Las Vegas NV 89123-6701 |
| Mailing Address |
8324 E Hartford Dr Suite 200 Scottsdale AZ 85255-7801 |
| Practice Telephone | 8773588648 |
| Practice Fax Number | 8778776875 |
| Mailing Telephone | 8773588648 |
| Mailing Fax Number | 8778776875 |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2019-03-28 |
| Authorized Official Name | MR. DOUG SHACKELL (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 4806469024 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
261Q0000X | NV | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Passport Health | Doing Business As Name - Organization |
| PPH Global Services, LLC. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659912533 | Passport Health Holdings, LLC | Preventive Medicine | 111 Williard Street, Suite Gc, Quincy, MA 02169-1200 | 2019-10-02 |
| 1336793843 | Passport Health Holdings, LLC | Community Health Worker | 545 Mainstream Drvie, Suite 401, Nashville, TN 37228-1231 | 2019-08-01 |
| 1093369597 | Passport Health Holdings, LLC | Community Health Worker | 901 E Saint Louis Street, Suite 107, Springfield, MO 65806-2574 | 2019-08-01 |
| 1801440318 | Passport Health Holdings, LLC | Community Health Worker | 5330 North Oak Trafficway, Suite 105, Kansas City, MO 64118-4600 | 2019-08-01 |
| 1902450406 | Passport Health Holdings, LLC | Community Health Worker | 345 Boylston Street Floor 2, Suite 202, Newton, MA 02459-2863 | 2019-08-01 |
| 1346701075 | Passport Health Holdings, LLC | Preventive Medicine | 563 W 500 South, Suite 215, Bountiful, UT 84010-8172 | 2019-03-26 |
| 1972085587 | Passport Health Holdings, LLC | Clinic/Center | 3375 E. Capital Circle Ne Bldg E, Suite 3, Tallahassee, FL 32308-3778 | 2018-08-30 |
| 1619488103 | Passport Health Holdings, LLC | Community Health Worker | 14985 W Bell Rd Bldg 12-a, Surprise, AZ 85374-3231 | 2017-10-24 |
| 1528593761 | Passport Health Holdings, LLC | Preventive Medicine | 18 Tremont Street, Suite 404, Boston, MA 02108-2304 | 2017-04-25 |
| 1578004008 | Passport Health Holdings, LLC | Preventive Medicine | 1116 E Route 66, Flagstaff, AZ 86001-4706 | 2017-03-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | PASSPORT HEALTH HOLDINGS, LLC | 8324 E. Hartford Dr. Ste. 200, Scottsdale, AZ 85255 |
| Street Address |
8766 S MARYLAND PKWY SUITE 104 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89123-6701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740894096 | Jpn Holdings Corp | Home Health Aide | 8275 S Eastern Ave Ste 246, Las Vegas, NV 89123 | 2020-09-03 |
| 1104463488 | Rafaat Yousif Rafael | Technician | 8365 Montgomery St, Las Vegas, NV 89123 | 2019-12-05 |
| 1386287357 | Nadhc At Eastern, Inc | Respite Care | 8695 Eastern Ave., Las Vegas, NV 89123 | 2019-10-23 |
| 1619523677 | Nadhc At Eastern, Inc | Clinic/Center | 8695 S. Eastern Ave., Las Vegas, NV 89123 | 2019-08-15 |
| 1437714995 | Vladimir Jose Pedraza | Technician | 8330 Collado St, Las Vegas, NV 89123 | 2019-05-09 |
| 1174026017 | Jenni Das | Behavior Technician | 62 E Serene Ave Unit 129, Las Vegas, NV 89123 | 2018-03-16 |
| 1134621717 | Catherine Domingo Leanu | Technician | 9490 Bermuda Road, Apt 1121, Las Vegas, NV 89123 | 2018-02-28 |
| 1801397583 | Titus Aldea | Technician | 8419 Yamhill St, Las Vegas, NV 89123 | 2018-02-27 |
| 1699291997 | Angel's Touch Home Care LLC | In Home Supportive Care | 8382 Marcasel Dr, Las Vegas, NV 89123 | 2017-08-17 |
| 1427578152 | Adrianna Jones | Rehabilitation Practitioner | 1901 S. Jones Blvd., Las Vegas, NV 89123 | 2017-06-23 |
| Find all providers in zip 89123 | ||||
| Taxonomy Code | 2083P0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Public Health & General Preventive Medicine |
| Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760043723 | Quality Health Partners Inc | Preventive Medicine | 2341 Renaissance Dr, Las Vegas, NV 89119-6191 | 2019-06-21 |
| 1093008674 | Donald Simon Kwalick | Preventive Medicine | 3025 Plaza De Monte, Las Vegas, NV 89102-4046 | 2011-05-16 |
| 1366543720 | John Philip Middaugh | Preventive Medicine | 613 Point Ridge Pl, Las Vegas, NV 89145-8810 | 2006-09-26 |
| 1194783530 | Bradley S Walker | Preventive Medicine | 1735 N Nellis Blvd Ste G, Las Vegas, NV 89115-3671 | 2006-05-03 |
| 1427666015 | Marc O Griofa | Preventive Medicine | 1581 N Main St, Las Vegas, NV 89101-1020 | 2020-07-20 |
| 1336557685 | Passport Health Holdings, LLC. | Preventive Medicine | 3211 N. Tenaya Way, Las Vegas, NV 85255 | 2014-07-31 |
| 1821414954 | Passport Health Holdings, LLC | Preventive Medicine | 1771 E Flamingo Rd, #b121, Las Vegas, NV 89119 | 2014-03-13 |
| 1982927166 | Cortland Jesse Lohff | Preventive Medicine | 280 S Decatur Blvd, Las Vegas, NV 89107-2936 | 2010-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912287 | Corazon Ilarina Ibarra | Preventive Medicine | 1495 Ridgeview Drive Suite 210, 1495 Ridgeview Drive Suite 210, Reno, NV 89519 | 2020-11-04 |
| 1477970093 | Esther Estes | Preventive Medicine | 2566 Orangeglory Dr, Henderson, NV 89052-2316 | 2014-03-20 |
| 1649696766 | Passport Health Holdings, LLC. | Preventive Medicine | 9190 Double Diamond Parkway, # 131, Reno, NV 89521 | 2014-03-13 |
| 1649225863 | Michael Julius Silvers | Preventive Medicine | 1701 N Green Valley Pkwy, Ste B, Henderson, NV 89074-5885 | 2006-05-24 |
| 1154396877 | Troy Wayne Ross | Preventive Medicine | 975 Ryland St, Ste 100, Reno, NV 89502-1667 | 2006-02-17 |
Please comment or provide details below to improve the information on PASSPORT HEALTH HOLDINGS, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.