NPIMap

Organization Active NPI

Passport Health Holdings, LLC.

Doing business as PPH Ohio, LLC.

  • Clinic/Center
  • Bluffton, SC
National Provider Identifier
1477970192
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PASSPORT HEALTH HOLDINGS, LLC.
Doing business as
PPH Ohio, LLC.
Practice address
29 Plantation Park Dr
B100 #117
Bluffton, SC 29910
Phone
(888) 909-6551
Fax
(480) 383-6567
NPI assigned
Mar 19, 2014
Last updated
Mar 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X OH Primary

Addresses

Primary practice location

29 Plantation Park Dr
B100 #117
Bluffton, SC 29910

Mailing address

8324 E Hartford Dr
#200
Scottsdale, AZ 85255
Phone (888) 909-6551

Other names 1

  • PPH Ohio, LLC. 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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458259200000",
    "number": "1477970192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8324 E HARTFORD DR",
            "address_2": "#200",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85255",
            "telephone_number": "888-909-6551",
            "fax_number": "480-383-6567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 PLANTATION PARK DR",
            "address_2": "B100 #117",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "29910",
            "telephone_number": "888-909-6551",
            "fax_number": "480-383-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSPORT HEALTH HOLDINGS, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-19",
        "last_updated": "2016-03-18",
        "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"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PPH Ohio, LLC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bluffton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.