Aegis Therapies - Colorado Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

AEGIS THERAPIES - COLORADO REHAB LLC

Practice address

2744 Grand Vista Cir
Colorado Springs, CO 80904-5261

Phone

(479) 201-6091

NPI assigned

Feb 8, 2024

Last updated

Feb 8, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracy McCall

Title

Credentialing

Phone

(479) 201-6091

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1053175174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4933 OLD GREENWOOD RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729036906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2744 GRAND VISTA CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809045261",
            "telephone_number": "479-201-6091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEGIS THERAPIES - COLORADO REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "MCCALL",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "479-201-6091"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.