Active NPI
Athletico LTD
Doing business as Athletico Physical Therapy
- Clinic/Center
- Adrian, MI
National Provider Identifier
1073920161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- ATHLETICO LTD
- Doing business as
- Athletico Physical Therapy
- Practice address
- 1801 W Maumee St
Suite 125
Adrian, MI 49221-1291 - Phone
- (517) 264-6141
- Fax
- (517) 263-5786
- NPI assigned
- Jul 21, 2014
- Last updated
- Feb 11, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Juana Granados
- Title
- Credentialing Manager
- Phone
- (630) 575-1980
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | MI | ||
| Occupational Therapist | 225X00000X | MI | ||
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
1801 W Maumee St
Suite 125
Adrian, MI 49221-1291
Mailing address
625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-1980
Other names 1
- ATHLETICO PHYSICAL THERAPY
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405900800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1581379200000",
"number": "1073920161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 ENTERPRISE DR",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605238813",
"telephone_number": "630-575-1980",
"fax_number": "630-928-5080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 W MAUMEE ST",
"address_2": "SUITE 125",
"city": "ADRIAN",
"state": "MI",
"postal_code": "492211291",
"telephone_number": "517-264-6141",
"fax_number": "517-263-5786"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATHLETICO LTD",
"organizational_subpart": "NO",
"enumeration_date": "2014-07-21",
"last_updated": "2020-02-11",
"certification_date": "2020-02-11",
"status": "A",
"authorized_official_last_name": "GRANADOS",
"authorized_official_first_name": "JUANA",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "630-575-1980"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "ATHLETICO PHYSICAL THERAPY",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "ATHLETICO PHYSICAL THERAPY",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Adrian, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.