NPIMap

Organization Active NPI

Athletico LTD

Doing business as Athletico Physical Therapy

  • Physical Therapist
  • Liberty, MO
National Provider Identifier
1114449857
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ATHLETICO LTD
Doing business as
Athletico Physical Therapy
Practice address
229 S Stewart Rd Ste E-3
Liberty, MO 64068-4206
Phone
(816) 656-3695
Fax
(816) 656-3696
NPI assigned
Jul 14, 2017
Last updated
Jul 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Juana Granados
Title
Credentialing Director
Phone
(630) 575-1980

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X
Occupational Medicine Clinic/Center 261QX0100X
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X

Addresses

Primary practice location

229 S Stewart Rd Ste E-3
Liberty, MO 64068-4206

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200

Other names 1

  • ATHLETICO PHYSICAL THERAPY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171211002357 MO Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4789602681 Receives reassigned benefits from 264 practitioners
1 other NPI on this enrollment
Practice locations: Saint Louis, MO; Saint Charles, MO; Rolla, MO; Raymore, MO; Perryville, MO; Kansas City, MO; O Fallon, MO; Liberty, MO…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

12404 S US Highway 71
Grandview, MO 64030
Phone (816) 285-0194

Practitioners & affiliated clinicians

Practitioners 272

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 272

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1114449857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 S STEWART RD STE E-3",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640684206",
            "telephone_number": "816-656-3695",
            "fax_number": "816-656-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETICO LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-14",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A",
        "authorized_official_last_name": "GRANADOS",
        "authorized_official_first_name": "JUANA",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTOR",
        "authorized_official_telephone_number": "630-575-1980"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATHLETICO PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.