PASSPORT HEALTH – NPI #1235568437
Clinic/Center

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

PASSPORT HEALTH is an AHC clinic located in LITTLE ROCK, AR. NPPES has assigned the NPI number 1235568437 to PASSPORT HEALTH on November 07, 2013. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PASSPORT HEALTH” is a dba name, the actual legal business name for this organization is PASSPORT HEALTH HOLDINGS, LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261Q00000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center.

The NPI profile was previously updated about 4 years ago on Mar 25, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PASSPORT HEALTH below.

NPI Profile for
PASSPORT HEALTH HOLDINGS, LLC

NPI Number
1235568437
Enumeration Date

(more than 12 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PASSPORT HEALTH HOLDINGS, LLC
Doing Business As (dba): PASSPORT HEALTH
Primary location
1701 CENTER VIEW DRIVE
SUITE 324
LITTLE ROCK, AR 72211-4308
Phone: (877) 358-8648 Fax: (877) 877-6875
Mailing address
668 N 44TH ST
SUITE 100W
PHOENIX, AZ 85008-6507
Phone: (877) 358-8648 Fax: (480) 546-3421
Organization Subpart
No
Authorized Official
PAUL FISHBURN
CHIEF OPERATING OFFICER
Phone: (480) 646-9020
Updated
Certification Date
Mar 25, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261Q00000X
- Clinic/Center (Primary)
AR
2083P0901X
- Preventive Medicine / Public Health & General Preventive Medicine

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.