MARATHON HEALTH, LLC (NPI# 1598205221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598205221 |
| Entity Type | Organization |
| Organization Name | MARATHON HEALTH, LLC |
| Other Organization Name | MARATHON HEALTH AT BREVARD SOUTH |
| Practice Address |
2550 Wingate Boulevard C/o Brevard Wellcare- South West Melbourne FL 32904 |
| Mailing Address |
20 Winooski Falls Way Ste 400 Winooski VT 05404-2239 |
| Practice Telephone | 8028570400 |
| Mailing Telephone | 8028570434 |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2017-02-28 |
| 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 | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Marathon Health at Brevard South | 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 |
| 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 |
| 1417511924 | Marathon Health, LLC | Nurse Practitioner | 725 Highway 142, Poplar Bluff, MO 63901-8159 | 2019-04-30 |
| 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 |
2550 WINGATE BOULEVARD C/O BREVARD WELLCARE- SOUTH |
| City | WEST MELBOURNE |
| State | FL |
| Zip Code | 32904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063066512 | Shepherd's Heart Ministries | Counselor | 900 S Wickham Rd, Melbourne, FL 32904 | 2019-08-01 |
| 1588138663 | Nicholle C Rothengass | Physician Assistant | 2263 W New Haven Ave # 350, W Melbourne, FL 32904 | 2019-01-11 |
| 1114407020 | Natalie Havkin | Speech-Language Pathologist | 250 S Wickham Rd., Melbourne, FL 32904 | 2018-08-20 |
| 1184119299 | Marni B Simon | Speech-Language Pathologist | 565 Acacia Ave, Melbourne Village, FL 32904 | 2018-06-30 |
| 1821588625 | Walden Psychological Services, LLC | Psychologist | 3400 Willowwood Dr, Melbourne, FL 32904 | 2018-05-16 |
| 1598276271 | Donetta Gwin Reynolds | Early Intervention Provider Agency | 764 Triples Crown Lane, West Melbourne, FL 32904 | 2017-10-20 |
| 1366875387 | Cancer Center of Melbourne LLC | Clinic/Center | 415 S. Wickham Rd., Melbourne, FL 32904 | 2013-08-13 |
| 1558704312 | Sandra Suzanne Borthwick | Social Worker | 569 Sylvia Rd, Melbourne, FL 32904 | 2013-04-11 |
| 1396983607 | Genesis | Skilled Nursing Facility | 2653 Reflections Pl, W. Melbourne, FL 32904 | 2009-01-23 |
| 1861647109 | Genesis Rehabilitation Services | Nursing Care | 7260-2 Greenboro Dr, West Melbourne, FL 32904 | 2008-12-01 |
| Find all providers in zip 32904 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1508463779 | Ashley Zanders Walton | General Practice | 75 Foxfire Ct, Quincy, FL 32351-7293 | 2020-10-01 |
| 1730796830 | Brid M Wade | General Practice | 3199 Cornell Dr, Gulf Breeze, FL 32563-2785 | 2020-09-23 |
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| Find all providers with the same taxonomy | ||||
| City | WEST MELBOURNE |
| Zip Code | 32904 |
Please comment or provide details below to improve the information on MARATHON HEALTH, LLC.
| 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.