Ethos Health Group Maryland 5 LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ETHOS HEALTH GROUP MARYLAND 5 LLC

Practice address

152 Rollins Ave Ste 210
Rockville, MD 20852-4008

Phone

(352) 732-5590

Fax

(352) 732-0292

NPI assigned

Jul 14, 2021

Organization subpart

No

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

Authorized official

Name

Jonathan Ray Walker, DC

Title

Owner/Operator

Phone

(352) 732-5590

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1164094652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 ROLLINS AVE STE 210",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524008",
            "telephone_number": "352-732-5590",
            "fax_number": "352-732-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 ROLLINS AVE STE 210",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524008",
            "telephone_number": "352-732-5590",
            "fax_number": "352-732-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHOS HEALTH GROUP MARYLAND 5 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "352-732-5590",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Estrada
• Jennifer Patricia Estrada
• Estheisy Estrella de la Cruz
• Prosper Eta
• Egbe Etah
• Skylar Ethridge
• Bithssie Etienne
• Emma Etienne
• Jena Lynne Etnoyer, ATC
• David Ayuk Etta

• Multi-Specialty Clinic/Center in Rockville, MD
• Providers in Rockville, MD by specialty
• Multi-Specialty Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.