Athletico Ltd
NPI 1083217467ActiveOrganization· Clinic/Center· O Fallon, MO
Clinic/Center in O Fallon, Missouri, registered in NPPES in November 2020. The authorized official on file is Juana Granados, Credentialing Manager. Enrolled in Medicare as dme supplier - independently-practicing physical therapist.
Overview
| NPI | 1083217467 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 18, 2020 |
| Last updated in NPPES | Nov 18, 2020 |
| Certified by provider | Nov 18, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X | — | — |
| Physical Therapist | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Independently-Practicing Physical Therapist (MO) |
|---|
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