Active NPI
Marathon Health LLC
- Nurse Practitioner
- Kalamazoo, MI
National Provider Identifier
1104318369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- MARATHON HEALTH LLC
- Practice address
- 3520 Covington Rd
Kalamazoo, MI 49001 - Phone
- (802) 857-0400
- NPI assigned
- Jun 4, 2018
- Organization subpart
- Yes
- Parent organization
- MARATHON HEALTH LLC
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | Primary |
Addresses
Primary practice location
3520 Covington Rd
Kalamazoo, MI 49001
Mailing address
20 Winooski Falls Way Ste 400
Winooski, VT 05404-2239
Phone (802) 857-0434
Other names 2
- Fabri Kal and Schupan Health Center
- Fabrikal Schupan Health Center
National Provider Directory
National Provider Directory- Tax ID family
- Marathon Health LLC
- Part of
- Marathon Health LLC
Organizations with this tax ID in the same state 3
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Family Medicine Physician
- Battle Creek, MI
- NPI 1386292068
-
- Clinic/Center
- Kalamazoo, MI
- NPI 1760160055
-
- Physician Assistant
- Holland, MI
- NPI 1881167245
Locations
3520 Covington Rd
Kalamazoo, MI 49001
Phone (269) 924-0500
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528070400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1529107200000",
"number": "1104318369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 WINOOSKI FALLS WAY STE 400",
"city": "WINOOSKI",
"state": "VT",
"postal_code": "054042239",
"telephone_number": "802-857-0434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3520 COVINGTON RD",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "49001",
"telephone_number": "802-857-0400"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARATHON HEALTH LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MARATHON HEALTH LLC",
"enumeration_date": "2018-06-04",
"last_updated": "2018-06-16",
"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": "Fabri Kal and Schupan Health Center",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Fabrikal Schupan Health Center",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.