NPIMap

Organization Active NPI

Athletico LTD

Doing business as Athletico Physical Therapy

  • Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1508537069
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ATHLETICO LTD
Doing business as
Athletico Physical Therapy
Practice address
4179 Lindell Blvd
Saint Louis, MO 63108-2913
Phone
(314) 944-0494
Fax
(314) 946-9001
NPI assigned
Sep 24, 2021
Last updated
Sep 24, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

4179 Lindell Blvd
Saint Louis, MO 63108-2913

Mailing address

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

Other names 1

  • Athletico Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Athletico Physical Therapy293 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632441600000",
    "number": "1508537069",
    "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": "4179 LINDELL BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082913",
            "telephone_number": "314-944-0494",
            "fax_number": "314-946-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETICO LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-24",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "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": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athletico Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.