PASSPORT HEALTH HOLDINGS, LLC (NPI# 1639595754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639595754 |
| Entity Type | Organization |
| Organization Name | PASSPORT HEALTH HOLDINGS, LLC |
| Other Organization Name | PASSPORT HEALTH |
| Practice Address |
118 Huxley Rd Ste 1 Knoxville TN 37922-3183 |
| Mailing Address |
8324 E Hartford Dr #200 Scottsdale AZ 85255 |
| Practice Telephone | 8773588648 |
| Practice Fax Number | 8778778675 |
| Mailing Telephone | 8889096551 |
| Mailing Fax Number | 4803836567 |
| Enumeration Date | 2014-03-13 |
| 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 |
|---|---|---|---|---|---|
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
TN | 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 |
| 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 |
118 HUXLEY RD STE 1 |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37922-3183 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184132185 | Kimberly Zitko | Pharmacist | 400 Goody's Lane, Knoxville, TN 37922 | 2018-01-12 |
| 1366959314 | Matthew Smith | Physician Assistant | 1424 Randall Park Dr, Knoxville, TN 37922 | 2017-12-29 |
| 1174052823 | 24/7 Healthcare, Inc. | Nursing Care | 110 Center Park Drive, Suite 101, Knoxville, TN 37922 | 2017-06-07 |
| 1023543477 | Open Arms Care Corp | Intermediate Care Facility, Mentally Retarded | 12625 S Northshore Dr, Knoxville, TN 37922 | 2017-04-24 |
| 1275905440 | Milligan Surgical Associates, Pllc | Surgery | 1919 Pinnacle Pointe Way, Knoxville, TN 37922 | 2015-10-27 |
| 1275904096 | Medical Necessities & Services LLC | Durable Medical Equipment & Medical Supplies | 9327 S Northshore Dr, Knoxville, TN 37922 | 2015-10-20 |
| 1841668126 | Chad Szala | Behavioral Analyst | 10721 Chapman Hwy #22, Knoxville, TN 37922 | 2015-09-03 |
| 1275916470 | Nikki Nicole Peoples | Acupuncturist | 10406 Jackson Oaks Way Ste A, Knoxville, TN 37922 | 2015-07-07 |
| 1538577747 | Susan Carter | Optometrist | 2053 Thunderhead Rd, Knoxville, TN 37922 | 2014-07-31 |
| 1366868135 | Heartland Infusion | Clinic/Center | 9943 Kingston Pike, Knoxville, TN 37922 | 2014-03-17 |
| Find all providers in zip 37922 | ||||
| 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 |
|---|---|---|---|---|
| 1922587237 | Brittany Nashay Houser | Preventive Medicine | 140 Dameron Ave, Knoxville, TN 37917-6413 | 2018-08-08 |
| 1124322920 | Get Well Clinic Knoxville | Preventive Medicine | 10932 Murdock Dr, Suite 101-b, Knoxville, TN 37932-3239 | 2011-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053933630 | Jzb Enterprises, LLC | Preventive Medicine | 905 20th Ave S Apt 1711, Nashville, TN 37203-3992 | 2020-05-17 |
| 1326452590 | Lifestyle Medicine Associates, LLC | Preventive Medicine | 481 Sterns Xing, Brentwood, TN 37027-5840 | 2014-06-16 |
| 1750622379 | Jacqueline Wheeler-coleman | Preventive Medicine | 1108 Twin Circle Dr, Nashville, TN 37217-4067 | 2013-03-06 |
| 1780956557 | Oluyomi Faparusi Sr. | Preventive Medicine | 1274 Wheatley Forest Dr, Brentwood, TN 37027-8342 | 2012-02-08 |
| 1750522025 | Julia Sewell Binford | Preventive Medicine | 2904 Polo Club Rd, Nashville, TN 37221-4342 | 2009-03-17 |
| 1972702819 | Jennifer Lowe Ellis | Preventive Medicine | 1539 Ashland City Rd Ste C, Clarksville, TN 37040-6416 | 2007-07-12 |
| 1467664623 | Caroline Campbell Mcgee | Preventive Medicine | 586 Fortress Blvd, Murfreesboro, TN 37128-4128 | 2007-05-03 |
| 1578789905 | Jacqulyn Mayre Diggs | Preventive Medicine | 4136 Mountain View Rd, Chattanooga, TN 37415-2034 | 2007-04-17 |
| 1588703615 | Pansy Hayes Davis | Preventive Medicine | 90 Rush St, Lexington, TN 38351 | 2007-02-05 |
| 1548306525 | Charlotte Deniece Coleman | Preventive Medicine | 295 Summar Avenue, West Tennesse Regional Office, Jackson, TN 38301 | 2007-01-29 |
| Find all providers with the same taxonomy | ||||
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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.