NPIMap

Organization Active NPI

Ethos Health Group Tbi Specialists, LLC

  • Multi-Specialty Clinic/Center
  • Ocala, FL
National Provider Identifier
1396407656
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ETHOS HEALTH GROUP TBI SPECIALISTS, LLC
Practice address
1541 SE 17TH St
Ocala, FL 34471-4607
Phone
(352) 732-5590
Fax
(352) 732-0292
NPI assigned
Oct 13, 2021
Last updated
Oct 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Authorized official

Name
Jonathan Ray Walker, DCNPI 1801092218
Title
Owner/Ceo
Phone
(352) 732-5590

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1541 SE 17TH St
Ocala, FL 34471-4607

Mailing address

1541 SE 17TH St
Ocala, FL 34471-4607
Phone (352) 732-5590

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL OCALA Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1396407656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 SE 17TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714607",
            "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": "1541 SE 17TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714607",
            "telephone_number": "352-732-5590",
            "fax_number": "352-732-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHOS HEALTH GROUP TBI SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER/CEO",
        "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": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "OCALA",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1541 SE 17th St",
            "city": "Ocala",
            "state": "FL",
            "country_code": "US",
            "postal_code": "344714607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.