OrganizationActive
Passport Health Holdings, LLC
NPI 1245871110 · Public Health & General Preventive Medicine Physician · Portland, ME
Provider details
- NPI number
- 1245871110
- Entity type
- Organization
- Primary specialty
- Public Health & General Preventive Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Dough Shackell, Director of Finance(480) 646-9024
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 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
22 Monument Square
Suite 507
Portland, ME 04101-4031
Phone: (877) 358-8648
Fax: (877) 877-6875
Street-level locationGet directions
Mailing address
8324 E Hartford Drive
Scottsdale, AZ 85255-7801
Other names (DBA / former)
- Doing business as
- Passport Health
Registry dates
- Enumerated
- 2019-10-02
- Last updated
- 2019-10-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.