NPIMap

Organization Active NPI

Marathon Health LLC

  • Physician Assistant
  • Brooklyn, OH
National Provider Identifier
1730712712
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
MARATHON HEALTH LLC
Practice address
7575 Northcliff Ave Ste 403
Brooklyn, OH 44144-3266
Phone
(216) 539-2702
NPI assigned
Feb 18, 2020
Last updated
Feb 18, 2020By the provider in NPPES
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
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

7575 Northcliff Ave Ste 403
Brooklyn, OH 44144-3266

Mailing address

PO Box 5
Winooski, VT 05404-0005

Other names 1

  • Laborers Local 310 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
36D2162819Laborers Local 310 Health Center7575 Northcliff Ave, Brooklyn, OH 44144Certificate of waiverFeb 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Marathon Health LLC166 organizations share this tax ID, including this one
Part of
Marathon Health LLC

Organizations with this tax ID in the same state 11

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

Locations

7575 Northcliff Ave
Ste 403
Cleveland, OH 44144
Phone (216) 539-2702

Practitioners & affiliated clinicians

Practitioners 3

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": "1581984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1730712712",
    "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": "7575 NORTHCLIFF AVE STE 403",
            "city": "BROOKLYN",
            "state": "OH",
            "postal_code": "441443266",
            "telephone_number": "216-539-2702"
        }
    ],
    "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": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laborers Local 310",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brooklyn, OH

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.
  • 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.