NPIMap

Organization Active NPI

Marathon Health LLC

  • Nurse Practitioner
  • Decatur, AL
National Provider Identifier
1407489479
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MARATHON HEALTH LLC
Practice address
154 Ipsco St
Decatur, AL 35601-7412
Phone
(802) 857-0400
NPI assigned
Feb 19, 2020
Organization subpart
Yes
Parent organization
MARATHON HEALTH LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

154 Ipsco St
Decatur, AL 35601-7412

Mailing address

PO Box 5
Winooski, VT 05404-0005

Other names 1

  • Wayne Farms Decatur 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 4

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

Locations

154 Ipsco St
Decatur, AL 35601

152 Ipsco St
Decatur, AL 35601

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1407489479",
    "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": "154 IPSCO ST",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356017412",
            "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": "2020-02-19",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-01",
        "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": "Wayne Farms Decatur",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Wayne Farms Decatur",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.