Athletico LTD
Organization Active NPI Clinic/Center · Hensley, AR
NPI 1003563727 · NPPES record last updated Jul 2, 2025
Key facts
- NPI
- 1003563727
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- ATHLETICO LTD
- Practice address
- 20800 Arch Street Pike
Hensley, AR 72065-9256 - Phone
- (501) 261-7722
- NPI assigned
- Mar 2, 2022
- Organization subpart
- No
Authorized official
- Name
- Juana Granados
- Title
- Credentialing Manager
- Phone
- (630) 575-1980
Practitioners 14
-
Holly Denise Calaway, DPT
-
Adam Parker Carson, D.P.T.
-
Madison Ferrell, DPT
-
Mallory Beth Grant, DPT
-
Clayton Jenks, DPT
-
Mack Gregory Pharr II, PT, DPT
-
Jonathan Bernard Randle, PT, DPT
-
Cynthia Weyrens, DPT
-
Rachel Michelle Schaefer, PT, DPT
-
Peighton S Taylor, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220818001013 | AR | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 4789602681 |
Receives reassigned benefits from 14 practitioners Practice locations: Hensley, AR; Bryant, AR; Benton, AR |
National Provider Directory
- Tax ID family
- Athleticoltd
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | |||
| Occupational Therapist |
225X00000X | |||
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
20800 Arch Street Pike
Hensley, AR 72065-9256
Mailing address
2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200
Other names
- Athletico Physical Therapy
Other providers in Hensley, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.