OrganizationActive
Passport Health Holdings, LLC
NPI 1215366406 · Clinic/Center · Boise, ID
Provider details
- NPI number
- 1215366406
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Paul Fishburn, Chief Operating Officer(480) 646-9020
Specialties & taxonomies
Ambulatory Health Care Facilities
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(77/100 index)
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
910 Main St
Suite 352
Boise, ID 83702-5720
Phone: (877) 358-8648
Fax: (877) 877-6875
Street-level locationGet directions
Mailing address
668 N 44th St
Phoenix, AZ 85008-6507
Other names (DBA / former)
- Doing business as
- Passport Health
Registry dates
- Enumerated
- 2013-11-07
- Last updated
- 2022-04-01
- Certified
- 2022-04-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.