MARATHON HEALTH, LLC (NPI# 1417511924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417511924 |
| Entity Type | Organization |
| Organization Name | MARATHON HEALTH, LLC |
| Practice Address |
725 Highway 142 Poplar Bluff MO 63901-8159 |
| Mailing Address |
Po Box 5 Winooski VT 05404-0005 |
| Practice Telephone | 5733123767 |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2019-04-30 |
| Authorized Official Name | JERRY FORD (CEO) |
| Authorized Official Telephone | 8028570400 |
| Is Organization Subpart | Y |
| Parent Organization Name | MARATHON HEALTH LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Briggs @ Stratton Poplar Bluff Health Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386292068 | Marathon Health, LLC | Family Medicine | 15745 S Airport Rd Bldg D, Battle Creek, MI 49015-8670 | 2019-08-27 |
| 1093376840 | Marathon Health, LLC | Nurse Practitioner | 807 Cherokee Dr Ste 5, Marshall, MO 65340-1690 | 2019-06-24 |
| 1033773544 | Marathon Health, LLC | Nurse Practitioner | 1930 S State St, Salt Lake City, UT 84115-2311 | 2019-04-30 |
| 1881167245 | Marathon Health, LLC | Physician Assistant | 284 Roost Ave, Holland, MI 49424-2032 | 2019-01-09 |
| 1639640527 | Marathon Health, LLC | Nurse Practitioner | 3880 Willowood Ave, Springdale, AR 72762-2774 | 2018-12-17 |
| 1952827818 | Marathon Health, LLC | Nurse Practitioner | 4700 Exchange Ct, Boca Raton, FL 33431-4450 | 2017-08-22 |
| 1598205221 | Marathon Health, LLC | General Practice | 2550 Wingate Boulevard, C/o Brevard Wellcare- South, West Melbourne, FL 32904 | 2017-02-28 |
| 1376083071 | Marathon Health, LLC | Nurse Practitioner | 7259 South Bingham Junction, C/o Chg- Ut Health Center, Midvale, UT 84047 | 2017-02-28 |
| 1598306656 | Marathon Health, LLC | Nurse Practitioner | 1515 June Ave, Panama City, FL 32405-3759 | 2019-09-30 |
| 1932755956 | Marathon Health, LLC | Nurse Practitioner | 81 E Broadway St, Jackson, OH 45640 | 2019-08-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | MARATHON HEALTH, LLC | 20 Winooski Falls Suite 400, Winooski, Vt 05404 |
| Colorado Business Entities | Marathon Health, LLC | 20 Winooski Falls Way, Suite 400, Winooski, VT 05404 |
| Oregon Corporations, Companies and Business Names | MARATHON HEALTH, LLC | 20 Winooski Falls Way Ste 400, Winooski, VT 05404 |
| Street Address |
725 HIGHWAY 142 |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-8159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891976361 | Cheri Lynne Morgan | Registered Nurse | 725 Highway 142, Poplar Bluff, MO 63901-8159 | 2007-11-26 |
| 1285009761 | Megan Lange-eads | Physical Therapist | 725 Highway 142, Poplar Bluff, MO 63901-8159 | 2015-12-09 |
| 1508286691 | Quad Med LLC | Clinic/Center | 725 Highway 142, Poplar Bluff, MO 63901 | 2014-04-16 |
| 1770732596 | Jay Robertson | Physical Therapist | 725 Highway 142, Poplar Bluff, MO 63901-8159 | 2008-09-17 |
| 1184870750 | Darrel Killian | Physical Therapist | 725 Highway 142, Poplar Bluff, MO 63901-8159 | 2008-08-14 |
| 1265688832 | Priscilla Mcgonigal | Physical Therapist | 725 Highway 142, Poplar Bluff, MO 63901-8159 | 2008-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568754851 | Jo A Crabtree | Nurse Practitioner | 65 County Road 527, Poplar Bluff, MO 63901-8029 | 2011-05-05 |
| 1669669537 | Sharon L Slayton | Nurse Practitioner | 2620 N. Westwood Blvd, Poplar Bluff, MO 63901-1908 | 2007-09-25 |
| 1750496253 | Amy E Shell | Nurse Practitioner | 2400 Lucy Lee Pkwy Ste A, Poplar Bluff, MO 63901-2427 | 2006-08-21 |
| 1568946515 | Carol Lee Pratt | Nurse Practitioner | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2018-09-15 |
| 1700314010 | Miranda Krishna | Nurse Practitioner | 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 | 2017-05-31 |
| 1750661138 | C & S Family Medical | Nurse Practitioner | 65 County Road 527, Poplar Bluff, MO 63901-8029 | 2011-08-17 |
| 1811293756 | Amy Michelle Pennington | Nurse Practitioner | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2011-02-09 |
| 1548562531 | Candice Leigh Copeland | Nurse Practitioner | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2010-11-23 |
| 1538482260 | Barbara Mcmains | Nurse Practitioner | 2620 N Westwood Blvd, Poplar Bluff, MO 63901-3396 | 2010-03-09 |
| 1851579742 | Victoria L Reinholdt | Nurse Practitioner | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2008-02-04 |
| Find all providers in POPLAR BLUFF | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.