NPIMap

Organization Active NPI

Marathon Community Wellness. Inc.

  • Community/Behavioral Health Agency
  • Gwynn Oak, MD
National Provider Identifier
1487238960
Registry record updated Sep 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MARATHON COMMUNITY WELLNESS. INC.
Practice address
6340 Security Blvd Ste B34 First Floor
Gwynn Oak, MD 21207-5173
Phone
(443) 273-4570
NPI assigned
May 10, 2021
Last updated
Sep 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2021

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

Authorized official

Name
Byron RandallNPI 1558944108
Title
Ceo/Owner
Phone
(443) 273-4570

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

6340 Security Blvd Ste B34 First Floor
Gwynn Oak, MD 21207-5173

Mailing address

6340 Security Blvd
Suite B34, First Floor
Gwynn Oak, MD 21207-5173
Phone (443) 273-4570

National Provider Directory

National Provider Directory

Locations

6340 Security Blvd
Ste B34
Gwynn Oak, MD 21207
Phone (443) 273-4570

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": "1620604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631318400000",
    "number": "1487238960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6340 SECURITY BLVD",
            "address_2": "SUITE B34, FIRST FLOOR",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212075173",
            "telephone_number": "443-273-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6340 SECURITY BLVD STE B34 FIRST FLOOR",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212075173",
            "telephone_number": "443-273-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARATHON COMMUNITY WELLNESS. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-09-11",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "BYRON",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "443-273-4570"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gwynn Oak, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.