PASSPORT HEALTH HOLDINGS, LLC (NPI# 1265861454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265861454 |
Entity Type | Organization |
Organization Name | PASSPORT HEALTH HOLDINGS, LLC |
Other Organization Name | PASSPORT HEALTH |
Practice Address |
1100 Summer St Ste 202 Stamford CT 06905-5520 |
Mailing Address |
8324 E Hartford Dr Ste 200 Scottsdale AZ 85255-5466 |
Practice Telephone | 8773588648 |
Practice Fax Number | 8778776875 |
Mailing Telephone | 8773588648 |
Mailing Fax Number | 8778776875 |
Enumeration Date | 2013-11-07 |
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 |
---|---|---|---|---|---|
N | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
Allopathic & Osteopathic Physicians | ||
N | 261Q00000X | Clinic/Center | CT | Ambulatory Health Care Facilities | |
Y | 261Q00000X | Clinic/Center | 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 |
1100 SUMMER ST STE 202 |
City | STAMFORD |
State | CT |
Zip Code | 06905-5520 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396367272 | Smartport LLC | Non-emergency Medical Transport (VAN) | C/o Mollo, 1111 Summer St, Stamford, CT 06905 | 2020-05-13 |
1245889096 | Anna Diamantis | Counselor | 1200 High Ridge Road, 2nd Floor, Stamford, CT 06905 | 2019-09-04 |
1871150409 | Connecticut Anesthesia Associates LLC | Anesthesiology | 1177 High Ridge Road, Stamford, CT 06905 | 2019-05-20 |
1518447887 | Alexandra Petrov | Lactation Consultant, Non-RN | 42 Riverside Ave, Stamford, CT 06905 | 2018-08-16 |
1235640327 | A&s Chemists LLC | Pharmacy | 910 Summer Ave, Stamford, CT 06905 | 2017-10-17 |
1659805117 | Evolution Physical Therapy, LLC | Clinic/Center | 7 Reynolds Ave, Stamford, CT 06905 | 2017-04-11 |
1326587841 | Karen Poggi | Speech-Language Pathologist | 30 Buxton Farm Rd., Suite 230, Stamford, CT 06905 | 2017-02-16 |
1811434871 | Christina Skuburids, LLC | Point of Service | 2043 Bedford Street, Stamford, CT 06905 | 2017-01-27 |
1669833513 | Christian Alvarez | Occupational Therapist | 15 First St Unit 1, Stamford, CT 06905 | 2016-03-18 |
1932500915 | Emily Krol | Psychologist | 29 Yale Court, Stamford, CT 06905 | 2014-09-10 |
Find all providers in zip 06905 |
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 |
---|---|---|---|---|
1245400894 | Stamford Health System, Inc | Clinic/Center | 32 Strawberry Hill Ave, Stamford, CT 06902-2630 | 2008-03-10 |
1558540054 | American Current Care Pa PC | Clinic/Center | 15 Commerce Road, 3rd Floor, Stamford, CT 06902 | 2007-10-31 |
1801231659 | Nordberg Plastic Surgery Center, LLC | Clinic/Center | 2001 W Main St, Suite 150, Stamford, CT 06902 | 2013-05-07 |
1932402286 | Tulin Koparan Md PC | Clinic/Center | 1275 Summer St, Suite 313, Stamford, CT 06905-5359 | 2010-12-08 |
1376728451 | Velez Chiropractic | Clinic/Center | 107 Glenbrook Rd, Stamford, CT 06902-3001 | 2008-01-08 |
1225171390 | Immediate Medical Care | Clinic/Center | 825 High Ridge Rd, Stamford, CT 06905-1904 | 2007-02-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265039093 | Thrive Haven LLC | Clinic/Center | 195 James St Fl 1, New Haven, CT 06513-3847 | 2020-10-05 |
1083229165 | Kusher Functional Medicine Center PC | Clinic/Center | 76 Eastern Blvd Ste 103, Glastonbury, CT 06033-4382 | 2020-09-15 |
1609414176 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 154 Toll Gate Rd, Groton, CT 06340-3444 | 2019-12-16 |
1811532500 | Alpha Wave Health Centers LLC | Clinic/Center | 10 Waterside Dr Ste 101, Farmington, CT 06032-3056 | 2019-11-17 |
1093282360 | Tms Neurohealth Pllc | Clinic/Center | 728 Post Rd E Ste 202, Westport, CT 06880-5200 | 2018-10-25 |
1982179784 | Wellness Primary Care Pllc | Clinic/Center | 291 S Lambert Rd Ste 5, Orange, CT 06477-3559 | 2018-10-08 |
1366953705 | Connecticut Neurodiagnostics, LLC | Clinic/Center | 83 Wooster Heights Rd., Suite 125, Office 145, Danbury, CT 06810 | 2017-10-12 |
1366993214 | Ascension Naturopathic Healing Center LLC | Clinic/Center | 175 Boston Post Road, Floor 1, Waterford, CT 06385 | 2016-10-16 |
1235588625 | Family Centers Inc. | Clinic/Center | 1 Wilbur Peck Ct Lowr Level, Greenwich, CT 06830-6354 | 2016-06-07 |
1578926424 | Chiropractic Wellness Center | Clinic/Center | 75 Hazard Ave Unit I, Enfield, CT 06082-3887 | 2016-03-29 |
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.