Sports Physical Therapy & Rehab Specialists SC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SPORTS PHYSICAL THERAPY & REHAB SPECIALISTS SC

Practice address

5340 Washington Ave
Racine, WI 53406-4229

Phone

(262) 638-1272

Fax

(262) 638-1287

NPI assigned

Jan 24, 2018

Organization subpart

No

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

Addresses

Other names 1

• ATHLETICO PHYSICAL THERAPY Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Athletico LTD

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1427264233

  Member Of

  NPD member

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

{
    "created_epoch": "1516752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522972800000",
    "number": "1407354517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "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": "5340 WASHINGTON AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064229",
            "telephone_number": "262-638-1272",
            "fax_number": "262-638-1287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS PHYSICAL THERAPY & REHAB SPECIALISTS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-24",
        "last_updated": "2018-04-06",
        "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"
        },
        {
            "organization_name": "ATHLETICO PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Spatafora, PHARMD
• Roger Theodore Spear, PHARMD
• Special Fitness LLC
• Spine and Joint Institute of Racine, Inc
• Spinealign Chiropractic, LLC
• Spring Dental Group, LTD.
• Paul William Springborn, RPH
• St. Luke'S Health Services, Inc.
• Michelle Irene Stabbe, LPN
• Brenda Lee Stapel, MS, OT

• Clinic/Center in Racine, WI
• Providers in Racine, WI by specialty
• Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; 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.