ATHLETICO LTD
NPI 1053195990
Clinic/Center in Oxford, MS

Q: What is Athletico Ltd's NPI number?

The NPI number for Athletico Ltd is 1053195990. It was assigned to this organization in the NPPES registry on August 22, 2023. The provider is doing business as Athletico Physical Therapy.

Q: What is Athletico Ltd's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Athletico Ltd was last updated on August 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 22, 2023

2205 JEFFERSON DAVIS DR, OXFORD, MS 38655(662) 238-2800(662) 238-2808 Get Directions Write a Review

NPPES record last updated: August 22, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Athletico Ltd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ATHLETICO LTD (NPI 1053195990), doing business as Athletico Physical Therapy, is a healthcare organization registered as a clinic/center in Oxford, Mississippi and active in the NPI registry since August 2023. The organization lists Juana Granados, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1053195990

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameATHLETICO LTD

Location Address2205 JEFFERSON DAVIS DROxford, MS 38655-5221

Mailing Address2122 York Rd Ste 300Oak Brook, IL 60523-1925 · (630) 575-1980 · Fax (630) 928-5080

Phone(662) 238-2800

Fax(662) 238-2808

Organization SubpartNo

Authorized OfficialJuana GranadosCredentialing Manager · (630) 575-1980

Enumeration DateAugust 22, 2023

NPPES CertifiedAugust 21, 2023

✔ NPI 1053195990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

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).

2205 JEFFERSON DAVIS DR, Oxford, MS 38655

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Other Names 1

Doing Business AsAthletico Physical Therapy

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Athletico Ltd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateMississippiEnrollment IDO20231018003487DME · Independently-Practicing Physical TherapistDue dateOctober 31, 2026

Source: CMS Revalidation Due Date List, October 2026 release.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. ANDREW ASHBY BUGLEWICZ PT

Physical Therapist