NPIMap

Organization Active NPI

Passport Health Holdings, LLC

Doing business as Passport Health

  • Community Health Worker
  • Jacksonville, FL
National Provider Identifier
1295686574
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Legal business name
PASSPORT HEALTH HOLDINGS, LLC
Doing business as
Passport Health
Practice address
8825 Perimeter Park Blvd
#301
Jacksonville, FL 32216
Phone
(877) 358-8648
Fax
(877) 877-6875
NPI assigned
Feb 4, 2026
Last updated
Feb 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X NU Primary

Addresses

Primary practice location

8825 Perimeter Park Blvd
#301
Jacksonville, FL 32216

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 LLC219 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

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

View all 21

Locations

8825 Perimeter Park Blvd
Ste 301
Jacksonville, FL 32216
Phone (904) 517-9531

NPI Registry JSON

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

{
    "created_epoch": "1770163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1295686574",
    "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": "8825 PERIMETER PARK BLVD",
            "address_2": "#301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "877-358-8648",
            "fax_number": "877-877-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSPORT HEALTH HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-04",
        "last_updated": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "SLACK",
        "authorized_official_first_name": "JUANA",
        "authorized_official_title_or_position": "MEDICAL BILLING SPECIALIST",
        "authorized_official_telephone_number": "480-646-9086"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Passport Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.