NPIMap

Organization Active NPI

Passport Health Holdings LLC

  • Clinic/Center
  • West Des Moines, IA
National Provider Identifier
1366871550
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PASSPORT HEALTH HOLDINGS LLC
Practice address
950 Office Park Rd
Ste 200B
West Des Moines, IA 50265-2548
Phone
(877) 358-8648
Fax
(877) 877-6875
NPI assigned
Nov 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Authorized official

Name
Mr. Doug Shackell
Title
Director of Finance
Phone
(480) 646-9024

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0901X
Clinic/Center 261Q00000X IA Primary

Addresses

Primary practice location

950 Office Park Rd
Ste 200B
West Des Moines, IA 50265-2548

Mailing address

8324 E Hartford Dr
Ste 200
Scottsdale, AZ 85255-5466
Phone (877) 358-8648

Other names 1

  • PPH Global Services LLC Other name

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 1

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

Locations

950 Office Park Rd
Ste 200B
West Des Moines, IA 50265
Phone (515) 244-7007

NPI Registry JSON

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1366871550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8324 E HARTFORD DR",
            "address_2": "STE 200",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555466",
            "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": "950 OFFICE PARK RD",
            "address_2": "STE 200B",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502652548",
            "telephone_number": "877-358-8648",
            "fax_number": "877-877-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSPORT HEALTH HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-07",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "SHACKELL",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "480-646-9024",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PPH Global Services LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.