NPIMap

Organization Active NPI

Passport Health Holdings, LLC.

  • Public Health & General Preventive Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1447676572
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
261Q0000X Issued in MN
Legal business name
PASSPORT HEALTH HOLDINGS, LLC.
Doing business as
PPH Global Services, LLC.
Practice address
1600 University Avenue W
Suite 207
Saint Paul, MN 55104
Phone
(877) 358-8648
Fax
(877) 877-6875
NPI assigned
Mar 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Mr. Paul Fishburn
Title
Chief Operating Officer
Phone
(480) 646-9020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2083P0901X 261Q0000X MN Primary

Addresses

Primary practice location

1600 University Avenue W
Suite 207
Saint Paul, MN 55104

Mailing address

668 N 44TH St
Suite 100W
Phoenix, AZ 85008
Phone (877) 358-8648

Other names 1

  • PPH Global Services, LLC. 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 4

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

Locations

1600 University Ave W
Ste 207
Saint Paul, MN 55104

NPI Registry JSON

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1447676572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 N 44TH ST",
            "address_2": "SUITE 100W",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85008",
            "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": "1600 UNIVERSITY AVENUE W",
            "address_2": "SUITE 207",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "877-358-8648",
            "fax_number": "877-877-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSPORT HEALTH HOLDINGS, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-13",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "FISHBURN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "480-646-9020",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "MN",
            "license": "261Q0000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PPH Global Services, LLC.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PPH Global Services, LLC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.