PASSPORT HEALTH HOLDINGS, LLC.


Address: 1600 University Ave W, #207, Saint Paul, MN 55104
Phone: 8889096551

PASSPORT HEALTH HOLDINGS, LLC. (NPI# 1447676572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1447676572
Entity Type Organization
Organization Name PASSPORT HEALTH HOLDINGS, LLC.
Other Organization Name PPH GLOBAL SERVICES, LLC.
Practice Address 1600 University Ave W
#207
Saint Paul
MN 55104
Mailing Address 8324 E Hartford Dr
#200
Scottsdale
AZ 85255
Practice Telephone 8889096551
Practice Fax Number 4803836567
Mailing Telephone 8889096551
Mailing Fax Number 4803836567
Enumeration Date 2014-03-13
Last Update Date 2016-03-18
Authorized Official Name DOUG SHACKELL (DIRECTOR OF FINANCE)
Authorized Official Telephone 4806469024
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2083P0901X Preventive Medicine
Specialization: Public Health & General Preventive Medicine
261Q0000X MN Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
PPH Global Services, LLC. Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1811313943 Passport Health Holdings, LLC. Preventive Medicine 2812 Emerywood Parkway, #160, Richmond, VA 23294 2014-03-13
1649696766 Passport Health Holdings, LLC. Preventive Medicine 9190 Double Diamond Parkway, # 131, Reno, NV 89521 2014-03-13
1336557685 Passport Health Holdings, LLC. Preventive Medicine 3211 N. Tenaya Way, Las Vegas, NV 85255 2014-07-31
1477970192 Passport Health Holdings, LLC. Clinic/Center 29 Plantation Park Dr, B100 #117, Bluffton, SC 29910 2014-03-19
1710303839 Passport Health Holdings, LLC. Preventive Medicine 200 Bartlett Dr, # 105, El Paso, TX 79912 2014-03-13
1720404858 Passport Health Holdings, LLC. Preventive Medicine 7003 Chadwick Dr, #227, Brentwood, TN 37027 2014-03-13

Other Data Sources

Entity Type Entity Name Entity Address
Massachusetts Corporations PASSPORT HEALTH HOLDINGS, LLC 8324 E. Hartford Dr. Ste. 200, Scottsdale, AZ 85255

Office Location

Street Address 1600 UNIVERSITY AVE W
#207
City SAINT PAUL
State MN
Zip Code 55104

Providers in the same location

NPI Name Taxonomy Address Enumeration
1801865894 Minnesota Foot and Ankle Clinic P A Podiatrist 1600 University Ave W, Suite 19-c, Saint Paul, MN 55104-3825 2006-03-14
1477035616 Jeffrey James Hansen Psychologist 1600 University Ave W, Saint Paul, MN 55104-3898 2018-09-04
1811418346 Cheri Ann Kuhn Counselor 1600 University Ave W, Saint Paul, MN 55104-3898 2017-07-06
1013451657 Lindsey Rae Benolken Counselor 1600 University Ave W, Ste 12, Saint Paul, MN 55104-3898 2016-12-16
1831649664 Kristine Kaschmitter Occupational Therapist 1600 University Ave W, Suite 10, Saint Paul, MN 55104-3898 2016-10-05
1639626054 Anna Ross Occupational Therapist 1600 University Ave W, Suite 10, Saint Paul, MN 55104-3898 2016-09-01
1972991354 Tegist Ayalew Nurse Practitioner 1600 University Ave W, Saint Paul, MN 55104-3898 2015-01-07
1609279157 Lauren Kijewski Specialist/Technologist 1600 University Ave W, Suite 10, Saint Paul, MN 55104-3898 2014-09-29
1720488711 Emily Yoon Penk-smith Occupational Therapist 1600 University Ave W, 10, Saint Paul, MN 55104-3898 2014-08-27
1891086005 Stefan A. Bailis Psychologist 1600 University Ave W, Suite 203, Saint Paul, MN 55104-3898 2011-04-21
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1891339131 Genoa Healthcare, LLC Durable Medical Equipment & Medical Supplies 1600 University Ave West, Suite 12, Room P, Saint Paul, MN 55104 2019-10-30
1629541644 Michael P Cain Counselor 1821 University Ave West, Suite N385, St. Paul, MN 55104 2019-01-03
1295219657 Awaken Recovery Center L.l.c Counselor 400 Suite D 393 North Dunlap, St Paul, MN 55104 2018-09-21
1285115634 American Current Care of Minnesota PC Clinic/Center 570 Asbury St Ste 101, Saint Paul, MN 55104 2018-08-23
1699262501 B & M Vital Homecare LLC. Home Health 1821 University Ave., W., Ste #s334, St. Paul, MN 55104 2018-04-16
1134621600 Lauren Fullerton Counselor 1821 University Ave W., Suite N385, St. Paul, MN 55104 2018-03-01
1265944672 Megan Manning Marriage & Family Therapist 475 Cleveland Ave. N., Suite 316, St. Paul, MN 55104 2017-10-26
1801305131 Foncham Buma Foncham Registered Nurse 856 University Avenue, W, St. Paul, MN 55104 2017-09-29
1750802476 Ha Vo Counselor 451 Lexington Parkway North, St. Paul, MN 55104 2017-07-03
1952831026 Noble Senior Center Inc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1094 University Ave W, Saint Paul, MN 55104 2017-06-12
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Taxonomy Information

Taxonomy Code 2083P0901X
Grouping Allopathic & Osteopathic Physicians
Classification Preventive Medicine
Specialization Public Health & General Preventive Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1457747974 Karen Joy Marienau Preventive Medicine 2095 James Ave, Saint Paul, MN 55105-1317 2015-04-10
1275727257 Michael S. K. Lockheart Preventive Medicine 1661 Saint Anthony Ave Fl 1, Saint Paul, MN 55104 2007-08-31
1730306846 Joel Emery Mccullough Preventive Medicine 555 Cedar St, Saint Paul, MN 55101 2007-04-19

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1316419377 Meeker-mcleod-sibley Community Health Services Preventive Medicine 114 North Holbombe Ave, Litchfield, MN 55355 2018-12-31
1043548423 Aaron Folsom Preventive Medicine 1300 S. 2nd Street, Suite 300, University of Minnesota Division of Epidemiology, Minneapolis, MN 55454-1015 2009-11-24
1114171352 Fred Thomas Nobrega Preventive Medicine 1118 Skyline Dr Sw, Rochester, MN 55902-0950 2008-11-14
1457497935 Ralph Dozier Morris Preventive Medicine 290 Painted Turtle Dr Nw, Bemidji, MN 56601-7787 2007-01-30
1881782712 Neal Ross Holtan Preventive Medicine 500 E Grant St, Apartment 2310, Minneapolis, MN 55404-1421 2006-10-10
1770977621 Nicholas Lehnertz Preventive Medicine White Earth Indian Health Center, 40520 County Highway 34, Ogema, MN 56569-9612 2015-03-27
1851535306 Richard Allan Nelson Preventive Medicine 6750 France Ave S, Ste 112, Edina, MN 55435-1903 2009-04-28
1376786079 Liza Milagros Ortiz Preventive Medicine 14701 Victor Hugo Blvd N, Hugo, MN 55038-4561 2009-04-09
1447439369 Abdelmadjid Guerrah Preventive Medicine 40520 County Highway 34, Ogema, MN 56569-9612 2007-10-27
1407052145 Dr. M. Warwick, LLC Preventive Medicine 1 Veterans Dr, 116a, Minneapolis, MN 55417-2309 2007-06-21
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Competitor

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City SAINT PAUL
Zip Code 55104

Improve Information

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Dataset Information

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.

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