Athletico Physical Therapy - Medicare Primary Care in Oklahoma City, OK

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Athletico Physical Therapy is a medicare enrolled primary clinic (Clinic/center) in Oklahoma City, Oklahoma. The current practice location for Athletico Physical Therapy is 12301 S Western Ave Ste A3, Oklahoma City, Oklahoma. For appointments, you can reach them via phone at (405) 200-1869. The mailing address for Athletico Physical Therapy is 2122 York Rd Ste 300, Oak Brook, Illinois and phone number is (630) 575-1980.

Athletico Physical Therapy is licensed to practice in (license number ). The clinic also participates in the medicare program and its NPI number is 1871249631. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (405) 200-1869.

Contact Information

Athletico Physical Therapy
12301 S Western Ave Ste A3
Oklahoma City
OK 73170-6085
(405) 200-1869
(405) 200-1873

Map and Direction


Primary Care Clinic Profile

Full NameAthletico Physical Therapy
SpecialityClinic/Center
Location12301 S Western Ave Ste A3, Oklahoma City, Oklahoma
Authorized Official Name and PositionJuana Granados (DIRECTOR, CREDENTIALING)
Authorized Official Contact6305751980
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Athletico Physical Therapy
2122 York Rd Ste 300
Oak Brook
IL 60523-1925

Ph: (630) 575-1980		Athletico Physical Therapy
12301 S Western Ave Ste A3
Oklahoma City
OK 73170-6085

Ph: (405) 200-1869

NPI Details:

NPI Number1871249631
Provider Enumeration Date03/01/2022
Last Update Date07/29/2026
Certification Date07/29/2026

Medicare PECOS Information:

Medicare PECOS PAC ID4789602681
Medicare Enrollment IDO20220414001805

Medical Identifiers

Medical identifiers for Athletico Physical Therapy such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1871249631NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261Q00000XClinic/center ()Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Athletico Physical Therapy acts as a billing entity for following providers:
Provider NameCarrie King
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1760413561
PECOS PAC ID: 4880680396
Enrollment ID: I20040421000989
Provider NameLeigh Marie Harvey
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1437249356
PECOS PAC ID: 8921173782
Enrollment ID: I20080814000031
Provider NameKylie L Cordell
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1417103508
PECOS PAC ID: 9032287594
Enrollment ID: I20081010000205
Provider NameRachel D Cooley
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1851521710
PECOS PAC ID: 7416120068
Enrollment ID: I20111027000325
Provider NameLacey Fairbrother
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1538442769
PECOS PAC ID: 4789858325
Enrollment ID: I20111117000293
Provider NameKristina K Mcanally
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1568896876
PECOS PAC ID: 6002031085
Enrollment ID: I20140707002031
Provider NameRachel L Branch
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1477954220
PECOS PAC ID: 6800118118
Enrollment ID: I20141121002253
Provider NameShelby Jordan Buoy
Provider TypePractitioner - Physical Medicine And Rehabilitation
Provider IdentifiersNPI Number: 1831579291
PECOS PAC ID: 5698087849
Enrollment ID: I20150701001190
Provider NameChristopher P Juneau
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1902043557
PECOS PAC ID: 8921058843
Enrollment ID: I20160629001679
Provider NameJason E Gates
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1811173743
PECOS PAC ID: 6406148576
Enrollment ID: I20160711000879
Provider NameCaitlyn R Horn
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1184072100
PECOS PAC ID: 3072807304
Enrollment ID: I20160810000617
Provider NameKendall L Blundell
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1649525726
PECOS PAC ID: 6204084122
Enrollment ID: I20160817000186
Provider NameAngel Dawn Haggard
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1609398841
PECOS PAC ID: 3577834712
Enrollment ID: I20170805000080
Provider NameKatie Diane Peeler
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1184116279
PECOS PAC ID: 8022366525
Enrollment ID: I20180731001710
Provider NameJoshua Johnson
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1194218628
PECOS PAC ID: 8325390370
Enrollment ID: I20181003000443
Provider NameNan Katherine Mcmahan
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1215386636
PECOS PAC ID: 8921338112
Enrollment ID: I20191002000381
Provider NameAllison Dieuthao-truong Lai
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1437718798
PECOS PAC ID: 7214341148
Enrollment ID: I20210204000066
Provider NameJohn Mcbride Jensen
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1760074512
PECOS PAC ID: 2062827553
Enrollment ID: I20210216000121
Provider NameMatthew Goecke
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1043885353
PECOS PAC ID: 8325449945
Enrollment ID: I20210702000060
Provider NameAllison Stallings
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1629647839
PECOS PAC ID: 1355733890
Enrollment ID: I20220113001601
Provider NameJodie Choy
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1801553151
PECOS PAC ID: 1658766829
Enrollment ID: I20220325000265
Provider NameKayla Enloe
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1932765104
PECOS PAC ID: 5294063269
Enrollment ID: I20220718002990
Provider NameShanna Rae Gray
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1750589081
PECOS PAC ID: 9234503624
Enrollment ID: I20230327001269
Provider NameLaura S Rachal
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1003670746
PECOS PAC ID: 6709221757
Enrollment ID: I20240229000613
Provider NameGarrett Mcdaniel
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1720835804
PECOS PAC ID: 6305380304
Enrollment ID: I20240702000178
Provider NameTaylor Matthews
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1467292516
PECOS PAC ID: 1951846906
Enrollment ID: I20240715000300
Provider NameLillian Lewis
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1841029899
PECOS PAC ID: 2961943154
Enrollment ID: I20240916000063
Provider NameTalon Nguyen
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1215696802
PECOS PAC ID: 6204352511
Enrollment ID: I20250430000321
Provider NameFaith M Sly
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1104618453
PECOS PAC ID: 9537672001
Enrollment ID: I20250627002636
Provider NameScott Carlton Wood
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1275410060
PECOS PAC ID: 1951898188
Enrollment ID: I20251013002369
Provider NameNoah B Hammons
Provider TypePractitioner - Physical Therapist In Private Practice
Provider IdentifiersNPI Number: 1467339879
PECOS PAC ID: 5092200998
Enrollment ID: I20251218001131

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.