Passport Health
NPI 1205255247 · Health Service Clinic/Center · Saint Louis, MO
Enrolled with Medicare as Part B Supplier - Mass Immunization (roster Biller Only) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Passport Health is a Health Service Clinic/Center organization in Saint Louis, MO (NPI 1205255247).
Provider details
- NPI number
- 1205255247
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Ltanya Garrison, President(314) 997-8100
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2014-04-07
- Last updated
- 2014-10-02
Frequently asked questions
- What is Passport Health's NPI number?
- Passport Health's National Provider Identifier (NPI) is 1205255247, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Passport Health?
- Passport Health is classified in the NPPES registry as Health Service Clinic/Center (Ambulatory Health Care Facilities).
- Where is Passport Health located?
- Passport Health's practice location on file with NPPES is 2025 S Brentwood Blvd, Saint Louis, MO 63144-1833.
- What is Passport Health's phone number?
- The practice phone number listed in the NPPES registry for Passport Health is (314) 997-8100.
- Does Passport Health accept Medicare?
- Passport Health is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Passport Health?
- The authorized official listed on Passport Health's NPPES record is Ltanya Garrison, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Passport Health's NPI active?
- Yes — Passport Health's NPI (1205255247) is active in the NPPES registry as of the last update on 2014-10-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.