NPIMap

Organization Active NPI

Marathon Health, LLC

  • Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1366028797
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MARATHON HEALTH, LLC
Practice address
10560 Dr Martin Luther King Jr St N
St Petersburg, FL 33716-3718
Phone
(802) 857-0400
NPI assigned
Mar 24, 2021
Organization subpart
Yes
Parent organization
MARATHON HEALTH, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

Name
Jeff Wells, MD
Title
Ceo
Phone
(802) 857-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

10560 Dr Martin Luther King Jr St N
St Petersburg, FL 33716-3718

Mailing address

20 Winooski Falls Way Ste 400
Winooski, VT 05404-2239

Other names 1

  • Jabil Medical and Wellness Center Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2220461Marathon Health, LLC10560 Dr Martin Luther King Jr St, Saint Petersburg, FL 33716Certificate of waiverApr 12, 2027

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 20

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

View all 20

Locations

10560 Dr Martin Luther King Jr St N
St Petersburg, FL 33716
Phone (407) 437-2535

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1366028797",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10560 DR MARTIN LUTHER KING JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337163718",
            "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": "2021-03-24",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "802-857-0400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jabil Medical and Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.