# MARATHON HEALTH LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MARATHON HEALTH LLC
- **Other names:** St Johns Nease
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1629601695
- **Legal business name:** MARATHON HEALTH LLC
- **Authorized official:** JERRY FORD (CEO)
- **Authorized official phone:** (802) 857-0400

## Contact information

- **Practice address:** 10430 RAY RD, PONTE VEDRA, FL 32081-8813
- **Practice address phone:** (904) 671-8329
- **Mailing address:** PO BOX 5, WINOOSKI, VT 05404-0005
- **Mailing address phone:** (802) 857-0400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/19/2020
- **Last updated:** 02/19/2020