PASSPORT HEALTH HOLDINGS, LLC (NPI# 1922453547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922453547 |
| Entity Type | Organization |
| Organization Name | PASSPORT HEALTH HOLDINGS, LLC |
| Other Organization Name | PASSPORT HEALTH |
| Practice Address |
2470 Windy Hill Rd Se Ste 107 Marietta GA 30067-8614 |
| Mailing Address |
8324 E Hartford Dr Suite 200 Scottsdale AZ 85255-7801 |
| Practice Telephone | 8773588648 |
| Practice Fax Number | 8778778675 |
| Mailing Telephone | 8773588648 |
| Mailing Fax Number | 6026065134 |
| Enumeration Date | 2016-05-02 |
| 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 |
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 |
2470 WINDY HILL RD SE STE 107 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30067-8614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689140022 | Sherry Wilson King | Marriage & Family Therapist | 1640 Powers Ferry Rd Blg 7, Ste 300, Marietta, GA 30067 | 2018-10-23 |
| 1053886861 | Precious Angel Home Care Services Inc | Adult Companion | 2470 Windy Hill Road, Marietta, Suite 253, Marietta, GA 30067 | 2018-10-08 |
| 1194206466 | Joshua P Moree | Chiropractor | 860 Franklin Gtwy Se Apt 111, Marietta, GA 30067 | 2018-08-24 |
| 1841778081 | Sun Pediatrics LLC | Pediatrics | 2520 Windy Hill Rd Se Ste 104, Marietta, GA 30067 | 2018-07-31 |
| 1508358714 | Mbs Wellness Group, LLC | Durable Medical Equipment & Medical Supplies | 62 Shawnee Trail Se, Marietta, GA 30067 | 2018-06-04 |
| 1497254213 | Allison M Jancik | Chiropractor | 1355 Terrell Mill Road Se, Bldg 1474, Ste 150, Marietta, GA 30067 | 2018-02-07 |
| 1801304969 | Danielle Ann Dietrich | Chiropractor | 805 Winterset Pkwy Se, Marietta, GA 30067 | 2018-01-11 |
| 1740794866 | Jessica Lofgren | Chiropractor | 1130 Northchase Pkwy Se Ste 125, Marietta, GA 30067 | 2017-11-28 |
| 1871026393 | Rhonda Dawes Milner | Counselor | 1640 Powers Ferry Rd Bldg 16, Suite 100, Marietta, GA 30067 | 2017-04-11 |
| 1457894537 | Carcelia Delk | Counselor | 1110 Augusta Dr Se, Marietta, GA 30067 | 2016-11-22 |
| Find all providers in zip 30067 | ||||
| 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 |
|---|---|---|---|---|
| 1467989574 | American Clinics for Preventive Medicine | Preventive Medicine | 1343 Terrell Mill Rd Se, Marietta, GA 30067-5489 | 2017-05-19 |
| 1669609442 | Dolly Penn White | Preventive Medicine | 1605 Roberta Dr Sw, Marietta, GA 30008-3855 | 2009-06-18 |
| 1770728768 | Carol H. Armann | Preventive Medicine | 310 E 8th St, Marietta, OH 45750-3379 | 2008-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730715137 | Ernest E Smith | Preventive Medicine | 115 W Dearborn Cir, Decatur, GA 30030-4474 | 2020-03-17 |
| 1033749288 | Atlanta Clinical Research Centers LLC | Preventive Medicine | 5673 Peachtree Dunwoody Rd Ste 440a, Atlanta, GA 30342-1797 | 2020-01-16 |
| 1316433105 | Thomas Boggs Richards | Preventive Medicine | 2067 Amberwood Way Ne, Atlanta, GA 30345-3903 | 2018-07-05 |
| 1871016592 | Sonja Suzzete Hutchins | Preventive Medicine | 435 Joseph E Lowery Blvd Sw, Atlanta, GA 30310-1471 | 2017-07-25 |
| 1275988891 | Passport Health Holdings LLC | Preventive Medicine | 315 W Ponce De Leon Ave Ste 585, Decatur, GA 30030-2400 | 2016-05-02 |
| 1619336286 | Antonio Neri | Preventive Medicine | 1600 Clifton Rd Ne # Mse-92, Atlanta, GA 30329-4018 | 2016-02-11 |
| 1134597057 | Zachary Taylor IIi | Preventive Medicine | 1710 Whitehouse Ct, Dalton, GA 30720-8523 | 2015-09-09 |
| 1730557729 | Populations and Interventions Team Company (pitc) | Preventive Medicine | 3182 Berthas Overlook, Douglasville, GA 30135-8458 | 2015-09-08 |
| 1609252626 | Anthony Robbins | Preventive Medicine | 2707 Whispering Pines Ct, Decatur, GA 30033-1453 | 2015-07-31 |
| 1962899948 | William Dana Flanders | Preventive Medicine | 2419 Highland Grv Ne, Atlanta, GA 30345-3895 | 2015-04-17 |
| 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.