Passport Health Holdings, LLC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

PASSPORT HEALTH HOLDINGS, LLC

Practice address

2204 Whitesburg Dr
Ste 305
Huntsville, AL 35801

Phone

(844) 358-8648

Fax

(877) 877-6875

NPI assigned

Oct 11, 2024

Organization subpart

No

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

Addresses

Other names 1

• Passport Health Doing business as

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.

• Passport Health Holdings, LLC

  • Clinic/Center
  • Birmingham, AL
  • NPI 1447676564
  NPD tax ID

Locations

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

{
    "created_epoch": "1728604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1508686908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 EAST OUTLIER BLV.",
            "address_2": "SUITE 100W",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850086507",
            "telephone_number": "844-358-8648",
            "fax_number": "877-877-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 WHITESBURG DR",
            "address_2": "STE 305",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35801",
            "telephone_number": "844-358-8648",
            "fax_number": "877-877-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSPORT HEALTH HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-11",
        "last_updated": "2024-10-11",
        "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": "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"
        }
    ]
}

• Kimberly Lynn Parton, M.S. CCC-SLP
• Boyd Partridge
• Pasadena Villa Alabama LLC
• Claudie Pascal, DDS
• Theresa L Passler, CRNA
• Erica Dawn Ryan Patchett
• Ashley Pate, CRNP
• Carl Brett Pate, LGSW
• Ericka Pate, MA, AADC
• Kelly C Pate, LPTA

• Community Health Worker in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Community Health Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.