NPIMap

Organization Active NPI

Athletico Excel Nebraska, LLC

  • Clinic/Center
  • Omaha, NE
National Provider Identifier
1356934616
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ATHLETICO EXCEL NEBRASKA, LLC
Practice address
12311 West Center Rd
Omaha, NE 68144
Phone
(402) 408-0384
Fax
(402) 973-1186
NPI assigned
Feb 18, 2021
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Juana Granados
Title
Credentialing Manager
Phone
(630) 575-1980

National Provider Directory

National Provider Directory
Tax ID family
Athletico Excel Nebraska LLC17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Clinic/Center 261Q00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

12311 West Center Rd
Omaha, NE 68144

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980

Other names 1

NPPES NPI Registry
  • Athletico Physical Therapy Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 18, 2021.

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1356934616",
    "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": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12311 WEST CENTER RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68144",
            "telephone_number": "402-408-0384",
            "fax_number": "402-973-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETICO EXCEL NEBRASKA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-01-28",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "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"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.