PASSPORT HEALTH HOLDINGS, LLC (NPI# 1811438351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811438351 |
| Entity Type | Organization |
| Organization Name | PASSPORT HEALTH HOLDINGS, LLC |
| Other Organization Name | PPH FRANCHISE HOLDINGS, LLC |
| Practice Address |
1760 E Pecos Rd Ste 301 Gilbert AZ 85295-3203 |
| Mailing Address |
8324 E Hartford Dr Ste 200 Scottsdale AZ 85255-7801 |
| Practice Telephone | 8773588648 |
| Practice Fax Number | 8778776875 |
| Mailing Telephone | 8773588648 |
| Mailing Fax Number | 8778776875 |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |
| 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 |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PPH Franchise Holdings, LLC | Other Name - Individual/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 |
1760 E PECOS RD STE 301 |
| City | GILBERT |
| State | AZ |
| Zip Code | 85295-3203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194753848 | Michael Drew | Physical Therapist | 1760 E Pecos Rd, Ste. 207, Gilbert, AZ 85295-3200 | 2006-06-30 |
| 1518354927 | Anjulie Broderick | Advanced Practice Midwife | 1760 E Pecos Rd, Ste 516, Gilbert, AZ 85295-3200 | 2015-04-23 |
| 1225462468 | Lahodas Pllc | Clinic/Center | 1760 E Pecos Rd, Suite #326, Gilbert, AZ 85295-3200 | 2013-08-23 |
| 1427319995 | Osna Pllc | Orthopaedic Surgery | 1760 E Pecos Rd, Ste 207, Gilbert, AZ 85295-3200 | 2012-05-31 |
| 1013280296 | Melissa R Peterson | Advanced Practice Midwife | 1760 E Pecos Rd, Suite 516, Gilbert, AZ 85295-3200 | 2012-02-17 |
| 1215248786 | Victoria Montgomery | Physical Therapist | 1760 E Pecos Rd, Gilbert, AZ 85295-3200 | 2010-06-29 |
| 1891925582 | Radiant Medical Imaging, LLC | Radiology | 1760 E Pecos Rd, Gilbert, AZ 85295-3200 | 2009-07-16 |
| 1083842470 | Jekyung Jang | Music Therapist | 1760 E Pecos Rd, Suite 307, Gilbert, AZ 85295-3200 | 2009-06-24 |
| 1710114574 | Kimberly K Swift | Advanced Practice Midwife | 1760 E Pecos Rd, Ste 516, Gilbert, AZ 85295-3200 | 2009-06-18 |
| 1982839726 | Marquis Diagnostic Imaging, LLC | Radiology | 1760 E Pecos Rd, Gilbert, AZ 85295-3200 | 2009-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508471368 | Lifequest Holding Company Gilbert, LLC | Physical Medicine & Rehabilitation | 4049 E. Williams Field Rd Suite 101, Gilbert, AZ 85295 | 2020-09-09 |
| 1255946075 | Lifequest Physical Medicine and Rehab | Physical Medicine & Rehabilitation | 4049 E. Williams Field Rd. Suite 101, Gilbert, AZ 85295 | 2020-09-09 |
| 1407467962 | Lifequest Physical Medicine and Rehab | Physical Medicine & Rehabilitation | 4049 E. Williams Field Rd, Suite 101, Gilbert, AZ 85295 | 2020-08-10 |
| 1275187718 | Guylene Lucien | Nurse Practitioner | 1689 S. Parkcrest Street, Gilbert, AZ 85295 | 2019-08-01 |
| 1326607144 | Hand Up Behavioral Services, LLC | Community/Behavioral Health | 4145 East Megan Street, Gilbert, AZ 85295 | 2019-06-06 |
| 1629582069 | Victoria Munoz Garcia | Naturopath | 920 S Williams Field Rd., Ste 102, Gilbert, AZ 85295 | 2017-11-21 |
| 1649798752 | Eureka Imperial Residence | Clinic/Center | 633 E Ray Road, Gilbert, AZ 85295 | 2017-09-08 |
| 1447791496 | Janine Patrice Faux | Counselor | 2563 S. Val Vista Drive St. 108, Gilbert, AZ 85295 | 2017-03-10 |
| 1437690450 | Erskine & Barber LLC | Clinic/Center | 5656 S. Power Rd #129, Gilbert, AZ 85295 | 2017-03-09 |
| 1164965448 | New Horizon Youth Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 774 E. Buffalo St, Chandler, AZ 85295 | 2016-11-18 |
| Find all providers in zip 85295 | ||||
| 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 |
|---|---|---|---|---|
| 1639312960 | Body Wise Weight Loss & Aesthetics Center Inc | Preventive Medicine | 3921 E Baseline Rd, Suite 100, Gilbert, AZ 85234-2727 | 2009-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227906 | Stchealth LLC | Preventive Medicine | 411 S 1st St, Phoenix, AZ 85004-2754 | 2020-05-26 |
| 1376033233 | Passport Health Holdings LLC | Preventive Medicine | 4647 N 32nd Street, Suite 115 1st Floor, Phoenix, AZ 85018-3346 | 2018-05-16 |
| 1578004008 | Passport Health Holdings, LLC | Preventive Medicine | 1116 E Route 66, Flagstaff, AZ 86001-4706 | 2017-03-16 |
| 1558802082 | Passport Health Holdings, LLC | Preventive Medicine | 2601 N. 3rd Street, Ste 102, Phoenix, AZ 85004-1145 | 2017-03-16 |
| 1366983801 | Passport Health Holdings, LLC | Preventive Medicine | 2034 E Southern Ave Ste L, Tempe, AZ 85282-7511 | 2017-03-16 |
| 1295119022 | Arizona Wellness Medicine LLC | Preventive Medicine | 8776 E Shea Blvd Ste 106-196, Scottsdale, AZ 85260-6629 | 2015-07-10 |
| 1285041822 | Jason Theodosakis | Preventive Medicine | 5257 N Via Sempreverde, Tucson, AZ 85750-5967 | 2014-07-15 |
| 1528369774 | Suzanne Lynn Valente | Preventive Medicine | 4775 S Butterfield Dr, Tucson, AZ 85714-3449 | 2010-11-04 |
| 1558690602 | Carlton Koons Meschievitz | Preventive Medicine | 222 Jacob Ln, Prescott, AZ 86303-8806 | 2009-12-21 |
| 1417181660 | James W. Justice | Preventive Medicine | 3663 E Kingler Spring Pl, Tucson, AZ 85718-2324 | 2009-05-03 |
| Find all providers with the same taxonomy | ||||
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.