PASSPORT HEALTH HOLDINGS, LLC (NPI# 1619394335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619394335 |
| Entity Type | Organization |
| Organization Name | PASSPORT HEALTH HOLDINGS, LLC |
| Other Organization Name | PASSPORT HEALTH |
| Practice Address |
37 Villa Rd Ste 301 Greenville SC 29615-3038 |
| Mailing Address |
8324 E Hartford Dr #200 Scottsdale AZ 85255 |
| Practice Telephone | 8773588648 |
| Practice Fax Number | 8778778675 |
| Mailing Telephone | 8889096551 |
| Mailing Fax Number | 4803836567 |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2018-08-29 |
| 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 | 261Q00000X | Clinic/Center | SC | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Passport Health | 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 |
37 VILLA RD STE 301 |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29615-3038 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194358051 | Adenike Orogade | Behavior Technician | 17 Caldedon Ct, Suite B, Greenville, SC 29615 | 2020-02-19 |
| 1629608369 | Jennifer Jacobsen | Behavior Technician | 17 Caldedon Court, Suite B, Greenville, SC 29615 | 2020-01-22 |
| 1932668217 | Carolina Orthopaedic and Neurosurgical Associates | Orthopaedic Surgery | Carolina Orthopaedic and Neurosurgical Associates, 220 Roper Mountain Road Extension, Greenville, SC 29615 | 2019-03-18 |
| 1255816070 | Trevis L Cureton | Pharmacist | 2401 East North St, Greenville, SC 29615 | 2018-09-27 |
| 1497232565 | Jacob J Fountain | Nurse Practitioner | 225 Enterprise Blvd, Suite 101, Greenville, SC 29615 | 2018-07-23 |
| 1346726924 | St. Francis Physician Services, Inc | Internal Medicine | 5 Hoke Smith Blvd, Greenville, SC 29615 | 2018-07-17 |
| 1558853101 | Alexandra Michelle Taylor | Audiologist | 200 Patewood Dr Ste 400, Greenville, SC 29615 | 2018-05-30 |
| 1316466543 | Mariah Hope Mosher | Behavioral Analyst | 7 Mckenna Commons Court, Greenvilee, SC 29615 | 2017-09-19 |
| 1326400896 | Karen L Heaps | Counselor | 3150 S. Hwy 14, The Pelham Center, Greenville, SC 29615 | 2016-03-24 |
| 1134589013 | Sharon Erk | Technician, Other | 2950 E.norths St, Greenville, OH 29615 | 2016-03-04 |
| Find all providers in zip 29615 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649802497 | Regenerative Health 360 LLC | Clinic/Center | 429 Roper Mountain Rd Ste 150, Greenville, SC 29615-4265 | 2020-02-10 |
| 1134688989 | Jean Barker Md Inc | Clinic/Center | 1659 E Union St, Greenville, MS 38703-3267 | 2019-03-19 |
| 1063909539 | Np Healthcare Clinic | Clinic/Center | 559a Highway 1 N, Greenville, MS 38701-3136 | 2018-04-19 |
| 1033638531 | Healthworks Med Group of South Carolina P C | Clinic/Center | 244 Terminal Rd Bldg 1045, Greenville, SC 29605-5508 | 2017-09-15 |
| 1659816932 | Proactive Md Sc,p.a. | Clinic/Center | 223 Adley Way, Greenville, SC 29607-6511 | 2016-12-22 |
| 1619336344 | John R Rowell Md21640 | Clinic/Center | 309 Belmont Ave, Greenville, SC 29601-4303 | 2016-02-23 |
| 1194192468 | Hammond Assessment Services, P.a. | Clinic/Center | 355 Woodruff Rd Ste 101, Greenville, SC 29607-3419 | 2015-08-21 |
| 1295157139 | Healthworks Med Group of South Carolina P C | Clinic/Center | 300 Garlington Rd, Greenville, SC 29615-4614 | 2014-01-13 |
| 1265779649 | Kristy D. Fox | Clinic/Center | 824 Mercer Rd, Greenville, PA 16125-8416 | 2013-01-06 |
| 1588972426 | Healthworks Med Group of South Carolina P C | Clinic/Center | 10 Parkway South, Greenville, SC 29615 | 2010-09-14 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 29615 |
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| 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.