NPIMap

Organization Active NPI

Passport Health Holdings, LLC

  • Community Health Worker
  • Dayton, OH
National Provider Identifier
1184596074
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Legal business name
PASSPORT HEALTH HOLDINGS, LLC
Practice address
10560 Success Lane
Suite D
Dayton, OH 45458
Phone
(877) 358-8648
Fax
(877) 877-6875
NPI assigned
Sep 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jauna Slack
Title
Medical Billing Specialist
Phone
(480) 646-9086

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 172V00000X Primary

Addresses

Primary practice location

10560 Success Lane
Suite D
Dayton, OH 45458

Mailing address

4343 East Outlier Blvd.
Suite 100W
Phoenix, AZ 85008-6507
Phone (877) 358-8648

Other names 1

  • Passport Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Passport Health Holdings LLC218 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 11

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

10560 Success Ln
Ste D
Dayton, OH 45458

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1758240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1184596074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 EAST OUTLIER BLVD.",
            "address_2": "SUITE 100W",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850086507",
            "telephone_number": "877-358-8648",
            "fax_number": "877-877-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10560 SUCCESS LANE",
            "address_2": "SUITE D",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45458",
            "telephone_number": "877-358-8648",
            "fax_number": "877-877-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSPORT HEALTH HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-19",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "SLACK",
        "authorized_official_first_name": "JAUNA",
        "authorized_official_title_or_position": "MEDICAL BILLING SPECIALIST",
        "authorized_official_telephone_number": "480-646-9086"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Passport Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.