Active NPI
Athletico LTD
Doing business as Athletico Physical Therapy
- Clinic/Center
- Lewisville, TX
National Provider Identifier
1902540933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- ATHLETICO LTD
- Doing business as
- Athletico Physical Therapy
- Practice address
- 4770 State Highway 121 Ste 130
Lewisville, TX 75056-2913 - Phone
- (469) 830-9030
- Fax
- (469) 390-0010
- NPI assigned
- Apr 26, 2022
- Last updated
- Apr 26, 2022
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Occupational Therapist | 225X00000X | |||
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
4770 State Highway 121 Ste 130
Lewisville, TX 75056-2913
Mailing address
2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Other names 1
- Athletico Physical Therapy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220812001394 | TX | DME Supplier - Independently-Practicing Physical Therapist | 4789602681 | Practice locations: Lewisville, TX |
National Provider Directory
National Provider Directory- Tax ID family
- Athleticoltd
Organizations with this tax ID in the same state 15
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650931200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1650931200000",
"number": "1902540933",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4770 STATE HIGHWAY 121 STE 130",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750562913",
"telephone_number": "469-830-9030",
"fax_number": "469-390-0010"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATHLETICO LTD",
"organizational_subpart": "NO",
"enumeration_date": "2022-04-26",
"last_updated": "2022-04-26",
"certification_date": "2022-04-26",
"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 Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.