Athletico Ltd
NPI 1114449857ActiveOrganization· Physical Therapist· Liberty, MO
Physical Therapist in Liberty, Missouri, registered in NPPES in July 2017. The authorized official on file is Juana Granados, Credentialing Director. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1114449857 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 14, 2017 |
| Last updated in NPPES | Jul 1, 2026 |
| Certified by provider | Jul 1, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
| Clinic/Center, Physical Therapy | 261QP2000X | — | — |
| Clinic/Center, Occupational Medicine | 261QX0100X | — | — |
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 Part B Supplier - Physical/Occupational Therapy Group in Private Practice (MO) |
|---|
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