NPIMap

Organization Active NPI

Marathon Health LLC

  • General Practice Physician
  • Saint Augustine, FL
National Provider Identifier
1245863232
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MARATHON HEALTH LLC
Practice address
580 State Road 206 W
Saint Augustine, FL 32086-7968
Phone
(904) 671-8337
NPI assigned
Feb 18, 2020
Organization subpart
Yes
Parent organization
MARATHON HEALTH LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

580 State Road 206 W
Saint Augustine, FL 32086-7968

Mailing address

PO Box 5
Winooski, VT 05404-0005

Other names 1

  • St Johns Menendez Other name

National Provider Directory

National Provider Directory
Tax ID family
Marathon Health LLC130 organizations share this tax ID, including this one
Part of
Marathon Health LLC

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Locations

580 State Road 206 W
Saint Augustine, FL 32086
Phone (904) 671-8337

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1245863232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054040005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 STATE ROAD 206 W",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320867968",
            "telephone_number": "904-671-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARATHON HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARATHON HEALTH LLC",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "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": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Johns Menendez",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; 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.