PASSPORT HEALTH HOLDINGS, LLC (NPI# 1972085587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972085587 |
| Entity Type | Organization |
| Organization Name | PASSPORT HEALTH HOLDINGS, LLC |
| Other Organization Name | PASSPORT HEALTH |
| Practice Address |
3375 E. Capital Circle Ne Bldg E Suite 3 Tallahassee FL 32308-3778 |
| Mailing Address |
8324 E Hartford Drive Suite 200 Scottsdale AZ 85255-7801 |
| Practice Telephone | 8773588648 |
| Practice Fax Number | 8778776875 |
| Mailing Telephone | 8773588648 |
| Mailing Fax Number | 8778776875 |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2019-07-30 |
| 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 | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
Allopathic & Osteopathic Physicians |
| 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 |
| 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 |
| 1558802082 | Passport Health Holdings, LLC | Preventive Medicine | 2601 N. 3rd Street, Ste 102, Phoenix, AZ 85004-1145 | 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 |
3375 E. CAPITAL CIRCLE NE BLDG E SUITE 3 |
| City | TALLAHASSEE |
| State | FL |
| Zip Code | 32308-3778 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215588306 | Jmc Tallahassee, LLC | Preventive Medicine | 1838 Jacliff Court, Tallahassee, FL 32308 | 2019-09-20 |
| 1972165108 | Covenant Home Health Care, LLC | Home Health | 1921 Capital Circle Ne, Tallahassee, FL 32308 | 2019-07-09 |
| 1548735798 | North Florida Rehab Solutions | Hospitalist | 1675 Riggins Road, Dr Steele Lancaster, Tallahassee, FL 32308 | 2018-10-03 |
| 1013491596 | Injury and Rehab Centers of North Florida, LLC | Neuromusculoskeletal Medicine & OMM | 2268 Wednesday Street, Tallahassee, Florida, FL 32308 | 2018-09-20 |
| 1487133625 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2634 Capital Circle Ne, Building C, Suite 156, Tallahassee, FL 32308 | 2018-08-08 |
| 1629566724 | Total Health & Wellness Home Care, LLC | Home Health | 1325 Mahan Dr., Tallahassee, FL 32308 | 2018-04-25 |
| 1669979480 | Beth North, Lcsw, LLC | Social Worker | 1325 Mahan Drive, Tallahassee, FL 32308 | 2018-04-09 |
| 1750885919 | Robert E Ashmore Jr Md | Obstetrics & Gynecology | 2770 Capitol Medical Blvd, Suite 100, Tallahassee, FL 32308 | 2018-03-22 |
| 1225547243 | William Michael Kunkle | Physician Assistant | 4004 Norton Ln, Suite 101, Tallahassee, FL 32308 | 2017-09-21 |
| 1235657834 | Traci R Raybon | Occupational Therapist | 1924 Hidden Valley, Tallahassee, FL 32308 | 2017-09-03 |
| Find all providers in zip 32308 | ||||
| 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 |
|---|---|---|---|---|
| 1104150366 | Florida Wellness Center of Tallahassee, Inc | Preventive Medicine | 2339 N Monroe St, Tallahassee, FL 32303-4733 | 2009-09-21 |
| 1033241856 | James J Green | Preventive Medicine | 3595 Crump Rd, Tallahassee, FL 32309-9291 | 2007-03-09 |
| 1073854469 | A Lynn Dolson, Md, LLC | Preventive Medicine | 1614 Mahan Center Blvd, Suite 103, Tallahassee, FL 32308-5474 | 2013-03-08 |
| 1477858181 | Sana, L.c. | Preventive Medicine | 2418 E Plaza Dr, Tallahassee, FL 32308-5301 | 2011-01-12 |
| 1063432045 | Charles Alan Lewis | Preventive Medicine | 1224 Ocala Rd, Tallahassee, FL 32304-1548 | 2006-07-20 |
| 1285670216 | Tammy L Blankenship | Preventive Medicine | 960 Learning Way, Tallahassee, FL 32306-4178 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588272868 | Lifegaines Medical and Aesthetics | Preventive Medicine | 3785 N Federal Hwy, Suite 150, Boca Raton, FL 33431 | 2020-07-22 |
| 1174147193 | Virtu30 Telehealth Services | Preventive Medicine | 1540 16th St Ne, Naples, FL 34120-3447 | 2020-06-05 |
| 1407477821 | Paramount Medical Specialists | Preventive Medicine | 5550 Glades Road Suite, Ste 500, #1024, Boca Raton, FL 33431 | 2020-04-27 |
| 1659990521 | Nickson Henry | Preventive Medicine | 4700 Portofino Way Apt 201, West Palm Beach, FL 33409-8174 | 2020-04-10 |
| 1609402619 | Bro Roc, LLC | Preventive Medicine | 1809 Ne 59th St, Fort Lauderdale, FL 33308-2443 | 2020-03-21 |
| 1306353776 | Roxanne Summerville | Preventive Medicine | 1064 N Tamiami Trl Unit 1302, Sarasota, FL 34236-2475 | 2018-01-06 |
| 1659884039 | Donald Joseph Crane | Preventive Medicine | 3125 Merion Dr, Miramar Beach, FL 32550-7887 | 2017-11-08 |
| 1801257183 | Sofia Abigail Funes | Preventive Medicine | 8 Hemlock Circle Ct, Ocala, FL 34472-9092 | 2016-03-14 |
| 1669850640 | Lareece Long | Preventive Medicine | 715 Bellshire Way, Winter Garden, FL 34787-2430 | 2015-05-11 |
| 1770908477 | Robert David Willix Jr. | Preventive Medicine | 501 E Camino Real, Boca Raton, FL 33432-6127 | 2014-03-04 |
| Find all providers with the same taxonomy | ||||
| City | TALLAHASSEE |
| Zip Code | 32308 |
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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.