Athletico LTD

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ATHLETICO LTD

Doing business as

Athletico Physical Therapy

Practice address

105B Quality LN
Senatobia, MS 38668-2317

Phone

(662) 562-9977

Fax

(662) 562-9978

NPI assigned

Aug 21, 2023

Last updated

Aug 21, 2023By the provider in NPPES

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 1

Addresses

Other names 1

• Athletico Physical Therapy Doing business as

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1861276024",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105B QUALITY LN",
            "city": "SENATOBIA",
            "state": "MS",
            "postal_code": "386682317",
            "telephone_number": "662-562-9977",
            "fax_number": "662-562-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETICO LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "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": "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"
        }
    ]
}

• All Children's Clinic,PC
• Barton Kyle Allen, D.P.T.
• Ally Therapy Specialists, LLC
• Aseracare Hospice - Senatobia, LLC (AseraCare Hospice)
• Associated Family Medical, LLC
• Michael Brian Bagwell, D.O.
• Jameria Bailey, LCSW
• Alexandra Claire Banker, NP
• Michaela Banks
• Darroth Leonard Barham, RPH

• Clinic/Center in Senatobia, MS
• Providers in Senatobia, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.