Athletico, LTD.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

060005437 Issued in IL

Legal business name

ATHLETICO, LTD.

Doing business as

Athletico Physical Therapy

Practice address

1155 S College Mall Rd
Suite a
Bloomington, IN 47401-6177

Phone

(812) 558-3356

Fax

(812) 558-3377

NPI assigned

Mar 24, 2017

Last updated

Apr 14, 2017By 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

Geri Cook

Title

VP of Billing Operations

Phone

(630) 575-1940

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": "1490313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492128000000",
    "number": "1932630670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6250",
            "fax_number": "630-575-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 S COLLEGE MALL RD",
            "address_2": "SUITE A",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474016177",
            "telephone_number": "812-558-3356",
            "fax_number": "812-558-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETICO, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-24",
        "last_updated": "2017-04-14",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "GERI",
        "authorized_official_title_or_position": "VP OF BILLING OPERATIONS",
        "authorized_official_telephone_number": "630-575-1940"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "060005437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athletico Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Justin Mark Atkins, M.D.
• Ross Augenstein
• Autism Consulting Services of Indiana, Inc.
• Kaylee Avalle, LMT, GTP, CPT
• Maryhelen Ayres, M.A., CPM

• Physical Therapist in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; 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.