NPIMap

Organization Active NPI

Marathon Health, LLC

  • Physician Assistant
  • Holland, MI
National Provider Identifier
1881167245
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
MARATHON HEALTH, LLC
Practice address
284 Roost Ave
Holland, MI 49424-2032
Phone
(802) 857-0400
NPI assigned
Jan 9, 2019
Organization subpart
Yes
Parent organization
MARATHON HEALTH LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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 AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

284 Roost Ave
Holland, MI 49424-2032

Mailing address

20 Winooski Falls Way Ste 400
Winooski, VT 05404-2239
Phone (802) 857-0400

Other names 1

  • Boar's Head Employee Health Center 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 3

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

Locations

284 Roost Ave
Holland, MI 49424
Phone (616) 377-4655

NPI Registry JSON

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546992000000",
    "number": "1881167245",
    "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",
            "telephone_number": "802-857-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 ROOST AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242032",
            "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": "2019-01-09",
        "last_updated": "2019-01-09",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boar's Head Employee Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.