PASSPORT HEALTH PC NPI 1154693695

NPI Information

  • NPI: 1154693695
  • Provider Name: PASSPORT HEALTH PC
  • Classification: Clinic/Center - 261QH0100X
  • Specialization: Health Service
  • Entity Type: Organization
  • Doing Business As: PASSPORT HEALTH TRIANGLE
  • CLIA Number: 34D2182038
  • Address: 100 PARK DR
    SUITE 201
    RESEARCH TRIANGLE PARK, NC
    ZIP 27709
  • Phone: (919) 781-0053

Map and Directions

Get Directions

NPI Details

PASSPORT HEALTH PC is a health service clinic center in Research Triangle Park, NC. PASSPORT HEALTH PC NPI is 1154693695. The provider is registered as an organization entity type.
The provider Is Doing Business As Passport Health Triangle.

The provider's business location address is:

100 PARK DR
SUITE 201
RESEARCH TRIANGLE PARK, NC
ZIP 27709-165
Phone: (919) 781-0053
Fax: (919) 481-0455

The provider's authorized official is Edith Bernosky .
The authorized official title is President and has the following contact phone number (919) 781-0053.

The CLIA number assigned to this NPI record is 34D2182038 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/30/2012 and was last updated on 1/30/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QH0100XClinic/CenterHealth Service200001186NORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI