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PASSPORT HEALTH
NPI 1215366406
Clinic/Center in Boise, ID

Active since November 07, 2013
910 MAIN ST, SUITE 352, BOISE, ID 83702(877) 358-8648(877) 877-6875 Get Directions Write a Review

NPPES record last updated: April 1, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 18, 2018, Jul 11, 2016, Mar 18, 2016 (3 updates tracked since 2016).

About Passport Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PASSPORT HEALTH (NPI 1215366406) is a healthcare organization registered as a clinic/center in Boise, Idaho and active in the NPI registry since November 2013. The organization lists Paul Fishburn, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1215366406
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NamePASSPORT HEALTH HOLDINGS, LLC
Location Address910 MAIN ST, SUITE 352Boise, ID 83702-5720
Mailing Address668 N 44th St, Suite 100wPhoenix, AZ 85008-6507 · (877) 358-8648 · Fax (877) 877-6875
Phone(877) 358-8648
Fax(877) 877-6875
Organization SubpartNo
Authorized OfficialPaul FishburnChief Operating Officer · (480) 646-9020
Enumeration DateNovember 7, 2013
Last NPPES UpdateApril 1, 20223 updates tracked since enumeration
NPPES CertifiedApril 1, 2022
✔ NPI 1215366406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
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).
Also ListedPreventive Medicine · Public Health & General Preventive MedicineTaxonomy 2083P0901X
910 MAIN ST, Boise, ID 83702
Open in Google Maps ↗

Other Names 1

Doing Business AsPassport Health

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. CHRISTINE RENE DROUILLARD LCSW
Social Worker (Clinical)
910 MAIN ST, SONNA BLDG, SUITE 231
BOISE, ID 83702
Ada County (208) 283-8362
ANGELA KAY HIDALGO
Massage Therapist
910 MAIN ST, SUITE 362
BOISE, ID 83702
Ada County (208) 861-1680

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Passport Health Holdings, LLC's NPI number?

The NPI number for Passport Health Holdings, LLC is 1215366406. It was assigned to this organization in the NPPES registry on November 7, 2013. The provider is doing business as Passport Health.

Where is Passport Health Holdings, LLC located?

Passport Health Holdings, LLC is located at 910 Main St Suite 352, Boise, ID 83702. The listed phone number is (877) 358-8648.

What is Passport Health Holdings, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Passport Health Holdings, LLC was last updated on April 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.