Aegis Group Practice LLC

Organization Active NPI Occupational Therapist · Roswell, GA

NPI 1083097992 · NPPES record last updated Nov 23, 2021

Key facts

NPI
1083097992
Entity type
Organization (NPI type 2)
Primary specialty
Occupational Therapist 225X00000X
Legal business name
AEGIS GROUP PRACTICE LLC
Practice address
11725 Pointe PL
Roswell, GA 30076-4636
Phone
(479) 201-2000
Fax
(479) 201-4801
NPI assigned
Jul 9, 2015
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

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 37

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225100000X
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225X00000X Yes
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP
235Z00000X

Addresses

Primary practice location

11725 Pointe PL
Roswell, GA 30076-4636

Mailing address

4933 Old Greenwood Rd
Fort Smith, AR 72903-6906
Phone (479) 201-6147

Other providers in Roswell, GA

All providers in Roswell, GA · Occupational Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.