Active NPI
Aegis Group Practice LLC
- Occupational Therapist
- Johns Creek, GA
National Provider Identifier
1083097075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 5690 State Bridge Rd
Johns Creek, GA 30022-6002 - Phone
- (479) 201-2000
- NPI assigned
- Jul 8, 2015
- Last updated
- Nov 22, 2021
- Organization subpart
- Yes
- Parent organization
- AEGIS THERAPIES, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Britt Jeffcoat
- Title
- Senior VP
- Phone
- (972) 372-6799
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | ||
| Occupational Therapist | 225X00000X | NU | Primary | |
| Speech-Language Pathologist | 235Z00000X | NU |
Addresses
Primary practice location
5690 State Bridge Rd
Johns Creek, GA 30022-6002
Mailing address
4933 Old Greenwood Rd
Fort Smith, AR 72903-6906
Phone (479) 201-6147
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| 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 |
Other NPIs on the same Medicare enrollment 37
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Aegis
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436313600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1637539200000",
"number": "1083097075",
"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",
"telephone_number": "479-201-6147",
"fax_number": "479-401-2239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5690 STATE BRIDGE RD",
"city": "JOHNS CREEK",
"state": "GA",
"postal_code": "300226002",
"telephone_number": "479-201-2000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AEGIS GROUP PRACTICE LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "AEGIS THERAPIES, INC.",
"enumeration_date": "2015-07-08",
"last_updated": "2021-11-22",
"certification_date": "2021-11-22",
"status": "A",
"authorized_official_last_name": "JEFFCOAT",
"authorized_official_first_name": "BRITT",
"authorized_official_title_or_position": "SENIOR VP",
"authorized_official_telephone_number": "972-372-6799"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johns Creek, GA
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- Isaac Kwame Adu
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- Advanced Urology Anesthesia, LLC
- Advanced Urology Institute of Georgia, LLC
- Aegis Group Practice LLC
- Agape Family Healthcare Services Inc.
- Agate Enterprise LLC (Agate Home Care)
- Ageless Homecare Services Inc
- Agilitas USA, Inc (Results Physiotherapy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.