Ethos Health Maryland 4, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

ETHOS HEALTH MARYLAND 4, LLC

Practice address

1411 Madison Park Dr
Glen Burnie, MD 21061-6185

Phone

(352) 732-5590

Fax

(352) 732-0292

NPI assigned

Nov 12, 2019

Organization subpart

No

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

Phone

(352) 732-5590

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jonathan Ray Walker, D.C.

  • Chiropractor
  • Ocala, FL
  • NPI 1801092218
  NPD (past) Authorized official

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1912542192",
    "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": "1411 MADISON PARK DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210616185",
            "telephone_number": "352-732-5590",
            "fax_number": "352-732-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHOS HEALTH MARYLAND 4, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-12",
        "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",
        "authorized_official_telephone_number": "352-732-5590",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "OCALA",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1411 Madison Park Dr",
            "city": "Glen Burnie",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210616185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Larry D. Epstein, D.D.S.
• Fer Eren, M.D.
• Adriana Espinoza, LMSW
• Estn85 (estn85 medical supply)
• Comfort Esunge Penda Sone
• Eugene Huang D.D.S., P.a.
• Eugene Hudyma DPM PA LLC
• Eugene O Hudyma DPM
• Eva Healthcare LLC
• Sarah Catherine Evans, MD

• Health Service Clinic/Center in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Health Service Clinic/Center in Maryland

• 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.