Organization
PASSPORT HEALTH HOLDINGS, LLC
Active
Organization
PASSPORT HEALTH HOLDINGS, LLC
Active
Other names
Passport Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUG SHACKELL (DIRECTOR OF FINANCE)
(480) 646-9024
Entity
Organization
Contact information
Practice address
901 E SAINT LOUIS STREET, SUITE 107, SPRINGFIELD, MO 65806-2574
(877) 358-8648
(877) 877-6875
Mailing address
8324 E HARTFORD DR., SUITE 200, SCOTTSDALE, AZ 85255-7801
(877) 358-8648
(877) 877-6875
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up