Organization Active NPI

Athelite Performance Therapy LLC

  • Rehabilitation Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1336712397
Registry record updated Oct 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
ATHELITE PERFORMANCE THERAPY LLC
Practice address
926 E Jackson St Ste 600
Phoenix, AZ 85034-2254
Phone
(480) 886-2253
Fax
(480) 790-4350
NPI assigned
Jul 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2024

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

Authorized official

Name
Dr. Johnathan Monteiro, DPTNPI 1639637614
Title
Owner
Phone
(480) 886-2253

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

926 E Jackson St Ste 600
Phoenix, AZ 85034-2254

Mailing address

926 E Jackson St Ste 600
Phoenix, AZ 85034-2254
Phone (480) 886-2253

Other names 1

  • athELITE PERFORMANCE THERAPY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250410001271 AZ Part B Supplier - Clinic/Group Practice 2466976550 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

925 E Jackson St Ste 600
Phoenix, AZ 85034
Phone (480) 886-2253

926 E Jackson St
Ste 600
Phoenix, AZ 85034
Phone (480) 886-2253

925 E Jackson St Ste 600
Phoenix, AZ 85034
Phone (480) 886-2253

1140 W Alameda Dr
Tempe, AZ 85282

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729900800000",
    "number": "1336712397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 E JACKSON ST STE 600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850342254",
            "telephone_number": "480-886-2253",
            "fax_number": "480-790-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 E JACKSON ST STE 600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850342254",
            "telephone_number": "480-886-2253",
            "fax_number": "480-790-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHELITE PERFORMANCE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-19",
        "last_updated": "2024-10-26",
        "certification_date": "2024-10-26",
        "status": "A",
        "authorized_official_last_name": "MONTEIRO",
        "authorized_official_first_name": "JOHNATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-886-2253",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "athELITE PERFORMANCE THERAPY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "athELITE PERFORMANCE THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2024; 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.