ATHLETICO LTD (NPI# 1578013298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578013298 |
| Entity Type | Organization |
| Organization Name | ATHLETICO LTD |
| Other Organization Name | ATHLETICO PHYSICAL THERAPY |
| Practice Address |
30785 Gratiot Ave Roseville MI 48066-1712 |
| Mailing Address |
600 Oakmont Ln Ste 600c Westmont IL 60559-5548 |
| Practice Telephone | 5862006601 |
| Practice Fax Number | 5862006602 |
| Mailing Telephone | 6305756200 |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2020-03-09 |
| Authorized Official Name | JUANA GRANADOS (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 6305751980 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| ATHLETICO PHYSICAL THERAPY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343596 | Athletico Ltd | Physical Therapist | 2090 W Grand River Ave Ste C, Okemos, MI 48864-1773 | 2020-10-12 |
| 1780203091 | Athletico Ltd | Occupational Therapist | 3050 Union Lake Rd Ste 3c, Commerce Township, MI 48382-4563 | 2020-04-16 |
| 1780218651 | Athletico Ltd | Physical Therapist | 141 S Parker St, Olathe, KS 66061-4043 | 2020-02-28 |
| 1568095602 | Athletico Ltd | Physical Therapist | 12404 S Us Highway 71, Grandview, MO 64030-1733 | 2020-02-18 |
| 1235762675 | Athletico Ltd | Physical Therapist | 4929 W Ray Rd Ste 4, Chandler, AZ 85226-6228 | 2020-02-13 |
| 1174154611 | Athletico Ltd | Physical Therapist | 3149 Crooks Rd, Troy, MI 48084-1633 | 2020-02-03 |
| 1063042794 | Athletico Ltd | Occupational Therapist | 2990 Golf Rd, Delafield, WI 53018-2179 | 2020-01-22 |
| 1558900944 | Athletico Ltd | Physical Therapist | 6070 W Bell Rd Ste A103, Glendale, AZ 85308-3774 | 2020-01-02 |
| 1669011466 | Athletico Ltd | Physical Therapist | 17020 Fort St, Riverview, MI 48193-6626 | 2019-12-27 |
| 1215572177 | Athletico Ltd | Occupational Therapist | 11207 Shawnee Mission Pkwy, Shawnee, KS 66203-3333 | 2019-11-14 |
| Street Address |
30785 GRATIOT AVE |
| City | ROSEVILLE |
| State | MI |
| Zip Code | 48066-1712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558607929 | Kris Chilson Wellman | Physical Therapist | 30785 Gratiot Ave, Roseville, MI 48066-1712 | 2012-12-12 |
| 1346767613 | Ambika Kunnath Puliyakote | Physical Therapist | 30785 Gratiot Ave, Roseville, MI 48066-1712 | 2017-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761400 | Louay Mansour Dds PC | Dentist | 27845 Gratiot Avenue, Roseville, MI 48066 | 2020-08-20 |
| 1558911842 | Jomy Jose | Nurse Practitioner | 25719 Salem St, Roseville, MI 48066 | 2019-09-18 |
| 1053963033 | Convenient Rv PC | Dentist | 19551 E. 10 Mile Rd, Roseville, MI 48066 | 2019-07-10 |
| 1063914539 | Colleen Meriweather | Registered Nurse | 27300 Spruce, Rosevilel, MI 48066 | 2018-03-01 |
| 1326565789 | Renee Suzette Hoelzeman | Nurse Practitioner | 18472 Meier St, Roseville, MI 48066 | 2017-08-27 |
| 1225561400 | Eugenia Dillard | Counselor | 28351 Gratiot Ave., Suite 3, Roseville, MI 48066 | 2017-04-05 |
| 1932651338 | Julie Plichota | Physical Therapist | 31120 Gratiot Ave, Roseville, MI 48066 | 2016-11-01 |
| 1699221325 | Jaquenta Glasker | Technician, Other | 26778 Rosewood, Roseville, MI 48066 | 2016-09-01 |
| 1609296144 | Peter Jajou | Dermatology | 18285 E 10 Mile Rd Ste 130, Roseville, MI 48066 | 2014-04-23 |
| 1619393899 | Katherine Michelle Johnson | Obstetrics & Gynecology | 29751 Little Mack Ave Ste B, Roseville, MI 48066 | 2014-03-11 |
| Find all providers in zip 48066 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275000283 | Saint Paul Hyperbaric Oxygen Center, P.a | Clinic/Center | 2151 Hamline Ave N Ste 111b, Roseville, MN 55113-4226 | 2018-10-29 |
| 1235666108 | Charter Professional Group Inc | Clinic/Center | 775 Sunrise Ave Ste 140, Roseville, CA 95661-4527 | 2017-05-22 |
| 1508979089 | Ecg Scanning & Medical Services Inc | Clinic/Center | 18223 E Ten Mile Road, Suite 300, Roseville, MI 48066-5281 | 2006-08-17 |
| 1881170397 | East West Acupuncture Center | Clinic/Center | 151 N Sunrise Ave Ste 819, Roseville, CA 95661-2928 | 2018-07-17 |
| 1518493170 | North Memorial Health Care | Clinic/Center | 1835 County Road C W, #150, Roseville, MN 55113-1352 | 2017-05-02 |
| 1972968337 | Core Chiropractic & Health | Clinic/Center | 1611 County Road B W Ste 106, Roseville, MN 55113-5021 | 2015-12-29 |
| 1295072254 | Diagnostic Evaluation Services | Clinic/Center | 800 Douglas Blvd, Roseville, CA 95678-2711 | 2013-01-11 |
| 1598032070 | Harper Dermatology P.C. | Clinic/Center | 18285 E 10 Mile Rd, Suite 130, Roseville, MI 48066-5802 | 2011-11-28 |
| 1326212184 | Community Drug& Alcohol Services Inc | Clinic/Center | 2675 Long Lake Rd Ste 125, Roseville, MN 55113-2823 | 2008-04-14 |
| 1275670754 | Putman Chiropractic Inc | Clinic/Center | 584 N Sunrise Ave, Ste. 130, Roseville, CA 95661-2862 | 2007-01-31 |
| Find all providers in ROSEVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.