PASSPORT HEALTH HOLDINGS LLC (NPI# 1669802559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669802559 |
| Entity Type | Organization |
| Organization Name | PASSPORT HEALTH HOLDINGS LLC |
| Other Organization Name | PPH OHIO LLC |
| Practice Address |
260 W Coleman Blvd Ste B Mt Pleasant SC 29464-3666 |
| Mailing Address |
8324 E Hartford Dr Suite 200 Scottsdale AZ 85255-5466 |
| Practice Telephone | 8773588648 |
| Practice Fax Number | 8778776875 |
| Mailing Telephone | 8773588648 |
| Mailing Fax Number | 8778776875 |
| Enumeration Date | 2013-11-14 |
| Last Update Date | 2016-07-12 |
| 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 |
|---|---|---|---|---|---|
| N | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 261Q00000X | Clinic/Center | SC | Ambulatory Health Care Facilities | |
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PPH Ohio LLC | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376033233 | Passport Health Holdings LLC | Preventive Medicine | 4647 N 32nd Street, Suite 115 1st Floor, Phoenix, AZ 85018-3346 | 2018-05-16 |
| 1275988891 | Passport Health Holdings LLC | Preventive Medicine | 315 W Ponce De Leon Ave Ste 585, Decatur, GA 30030-2400 | 2016-05-02 |
| 1336579226 | Passport Health Holdings LLC | Clinic/Center | 1402 Shepard Dr, Ste 101, Sterling, VA 20164-4425 | 2013-11-14 |
| 1598195489 | Passport Health Holdings LLC | Clinic/Center | 5890 Sawmill Rd, Suite 100, Dublin, OH 43017-1591 | 2013-11-14 |
| 1518397405 | Passport Health Holdings LLC | Preventive Medicine | 400 N Center Drive, Suite 108, Norfolk, VA 23502-0002 | 2013-11-14 |
| 1245660133 | Passport Health Holdings LLC | Clinic/Center | 512 Westwood Office Park, Fredricksburg, VA 22401-5112 | 2013-11-14 |
| 1609206564 | Passport Health Holdings LLC | Preventive Medicine | 2318-b Sunset Blvd, West Columbia, SC 29169-4716 | 2013-11-13 |
| 1043640048 | Passport Health Holdings LLC | Preventive Medicine | 3691 Palmetto Point Blvd, Ste 301, Myrtle Beach, SC 29588-1202 | 2013-11-13 |
| 1003245291 | Passport Health Holdings LLC | Preventive Medicine | 6355 Nw 36th St Ste 600, Virginia Gardens, FL 33166-7027 | 2013-11-07 |
| 1407189392 | Passport Health Holdings LLC | Preventive Medicine | 8249 W 95th St, Ste 105, Overland Park, KS 66212-3200 | 2009-09-10 |
| Street Address |
260 W COLEMAN BLVD STE B |
| City | MT PLEASANT |
| State | SC |
| Zip Code | 29464-3666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811548241 | Bradley Paul Anuszkiewicz | Chiropractor | 1501 Johnnie Dodds Blvd, Suite C, Mount Pleasant, SC 29464 | 2019-09-26 |
| 1447808696 | Laura Mariah Crouse | Speech-Language Pathologist | Coastal Therapy Services, 1127 Queensborough Blvd, Mt Pleasant, SC 29464 | 2019-08-30 |
| 1912461807 | Independent Optical | Optometrist | 1710 Shoremead Rd, Suite 420, Mount Pleasant, SC 29464 | 2019-01-25 |
| 1417446204 | Michael Adam Sugarman | Clinical Neuropsychologist | 1459 Stuart Engals Blvd Ste 204a, Mt Pleasant, SC 29464 | 2018-05-07 |
| 1578064192 | Ancillary Specialists LLC | Durable Medical Equipment & Medical Supplies | 636 Long Point Road, Unit G, #19, Mount Pleasant, SC 29464 | 2018-02-28 |
| 1346769015 | Christin Solomon Zerega | Counselor | Lowcountry Psychiatry Group, 913 Bowman Rd, #4, Mount Pleasant, SC 29464 | 2017-09-14 |
| 1336660315 | Charleston Neuropsychology LLC | Psychologist | 1459 Stuart Engals Blvd., Suite 204a, Mount Pleasant, SC 29464 | 2017-06-29 |
| 1790219970 | Adam Hudepohl | Family Medicine | 1400 Ben Sawyer Blvd, Mt Pleasant, SC 29464 | 2017-04-14 |
| 1386181204 | Alicia Taylor | Speech-Language Pathologist | 381 Stonewall Ct Apt 6207, Mount Pleasant, SC 29464 | 2017-01-30 |
| 1285181941 | Tara Lynn Mast | Physical Therapist | 1400 Caliper Oak Circle, Apt 316, Mount Pleasant, SC 29464 | 2016-09-09 |
| Find all providers in zip 29464 | ||||
| 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 |
|---|---|---|---|---|
| 1023543519 | Woods Family Practice LLC | Clinic/Center | 5401 Spring St, Mt Pleasant, WI 53406-2911 | 2017-04-22 |
| 1235373747 | Belle Hall Chiropractic Services, LLC | Clinic/Center | 721 Long Point Rd, Suite 403, Mt Pleasant, SC 29464-8297 | 2009-04-28 |
| 1538297205 | David Smith Chiropractic LLC | Clinic/Center | 895 Houston Northcutt Blvd, Mt Pleasant, SC 29464-3446 | 2007-03-02 |
| 1255356911 | Frick Hospital | Clinic/Center | 508 S Church St, Mt Pleasant, PA 15666 | 2006-07-13 |
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| 1932716867 | Living Well Chiropractic | Clinic/Center | 3786 Farrs Bridge Rd Ste E, Easley, SC 29640-9345 | 2020-09-24 |
| 1649802497 | Regenerative Health 360 LLC | Clinic/Center | 429 Roper Mountain Rd Ste 150, Greenville, SC 29615-4265 | 2020-02-10 |
| 1912537119 | Fairfield Medical Associates, Pa | Clinic/Center | 428 Mcnulty St Ste 3, Blythewood, SC 29016-8786 | 2020-01-16 |
| 1861037574 | Senior Centers of Cherokee County | Clinic/Center | 499 W Rutledge Ave, Gaffney, SC 29341-1639 | 2019-11-18 |
| 1093366056 | Simply Me Infusion Center LLC | Clinic/Center | 1601 N Oak St Ste 307, Myrtle Beach, SC 29577-3579 | 2019-09-21 |
| 1023677945 | Healogics Specialty Physicians of South Carolina, LLC | Clinic/Center | 1630 Skylyn Drive, Suite 420, Spartanburg, SC 29307 | 2019-06-13 |
| 1285290270 | Caresouth Carolina, Inc. | Clinic/Center | 810 Brown St Ste 1, Bishopville, SC 29010-1176 | 2019-05-15 |
| 1750865622 | Merge Medical Analytics | Clinic/Center | 180 Wingo Way Ste 106, Mount Pleasant, SC 29464-1810 | 2018-09-18 |
| 1245718444 | Rapha Wells Primary Health Care | Clinic/Center | 1013 Kincaid Bridge Rd, Winnsboro, SC 29180-7113 | 2018-07-31 |
| Find all providers with the same taxonomy | ||||
| City | MT PLEASANT |
| Zip Code | 29464 |
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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.