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PASSPORT HEALTH HOLDINGS, LLC
NPI 1245871110
Preventive Medicine - Public Health & General Preventive Medicine in Portland, ME

Active since October 02, 2019
22 MONUMENT SQUARE, SUITE 507, PORTLAND, ME 04101(877) 358-8648(877) 877-6875 Get Directions Write a Review

NPPES record last updated: October 2, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Passport Health Holdings, Llc NPPES

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

PASSPORT HEALTH HOLDINGS, LLC (NPI 1245871110), doing business as Passport Health, is a healthcare organization registered as a public health & general preventive medicine in Portland, Maine and active in the NPI registry since October 2019. The organization lists Dough Shackell, Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1245871110
Entity TypeOrganization
Primary Taxonomy2083P0901X
Legal Business NamePASSPORT HEALTH HOLDINGS, LLC
Location Address22 MONUMENT SQUARE, SUITE 507Portland, ME 04101-4031
Mailing Address8324 E Hartford Drive, Suite 200Scottsdale, AZ 85255-7801 · (877) 358-8648 · Fax (877) 877-6875
Phone(877) 358-8648
Fax(877) 877-6875
Organization SubpartNo
Authorized OfficialDough ShackellDirector Of Finance · (480) 646-9024
Enumeration DateOctober 2, 2019
✔ NPI 1245871110 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPreventive Medicine · Public Health & General Preventive MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2083P0901X
Definition
Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings.
22 MONUMENT SQUARE, Portland, ME 04101
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Other Names 1

Doing Business AsPassport Health

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

JEFFREY BLAKE LCSW
Social Worker (Clinical)
22 MONUMENT SQUARE, #403
PORTLAND, ME 04101
Cumberland County (207) 749-9075

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 1245871110. It was assigned to this organization in the NPPES registry on October 2, 2019. The provider is doing business as Passport Health.

Where is Passport Health Holdings, LLC located?

Passport Health Holdings, LLC is located at 22 Monument Square Suite 507, Portland, ME 04101. The listed phone number is (877) 358-8648.

What is Passport Health Holdings, LLC's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Public Health & General Preventive Medicine, with taxonomy code 2083P0901X.

When was this NPI record last updated?

The NPPES record for Passport Health Holdings, LLC was last updated on October 2, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.