Marathon Health, Inc.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

MARATHON HEALTH, INC.

Practice address

4725 Village Plaza Loop
Suite 100, C/O Lane County Employee Health Center
Eugene, OR 97401-6677

Phone

(802) 857-0400

NPI assigned

Oct 30, 2015

Organization subpart

Yes

Parent organization

MARATHON HEALTH, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jerry Ford

Title

Ceo

Phone

(802) 857-0400

Specialties & licenses 1

Addresses

Other names 1

• Marathon Health at Lane Other name

Tax ID family

Marathon Health LLC130 organizations share this tax ID, including this one

Part of

Marathon Health LLC

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446163200000",
    "number": "1013389931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WINOOSKI FALLS WAY",
            "address_2": "SUITE 400",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054042228",
            "telephone_number": "802-857-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 VILLAGE PLAZA LOOP",
            "address_2": "SUITE 100, C/O LANE COUNTY EMPLOYEE HEALTH CENTER",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016677",
            "telephone_number": "802-857-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARATHON HEALTH, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARATHON HEALTH, INC.",
        "enumeration_date": "2015-10-30",
        "last_updated": "2015-10-30",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "802-857-0400"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marathon Health at Lane",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tracie Manso, L.M.T.
• Desiree Nicole Mantey
• Sidra Manzoor
• Melanie Maples, LCSW, QMHPC, CADCIII
• Jennifer Lee Mappus, PHARMD
• Bethanie Suzanne Marchese
• Garrett T Marco
• Andrea Marcotte
• Katherine S Marcotte, RD CDE
• Kayla Ann Marcoulier, NP

• Nurse Practitioner in Eugene, OR
• Providers in Eugene, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.