Aegis Group Practice LLC
Organization Active NPI Physical Therapist · Augusta, GA
NPI 1013378256 · NPPES record last updated Nov 22, 2021
Key facts
- NPI
- 1013378256
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 945 Broad St
Augusta, GA 30901-1289 - Phone
- (479) 201-2000
- NPI assigned
- Mar 16, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- AEGIS THERAPIES, INC.
Authorized official
- Name
- Britt Jeffcoat
- Title
- Senior VP
- Phone
- (972) 372-6799
Other NPIs on the same Medicare enrollment 37
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150916001644 | GA | Part B Supplier - Clinic/Group Practice | 5193036432 |
Receives reassigned benefits from 34 practitioners 37 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Canton, GA; Suwanee, GA |
National Provider Directory
- Part of
- Aegis
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
945 Broad St
Augusta, GA 30901-1289
Mailing address
2601 Network Blvd Ste 102
Frisco, TX 75034-9092
Phone (972) 372-6779
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All providers in Augusta, GA · Physical Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.