Aegis Group Practice LLC
Organization Active NPI Physical Therapist · Dayton, OH
NPI 1083466064 · NPPES record last updated Apr 3, 2024
Key facts
- NPI
- 1083466064
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 280 Walden Way
Dayton, OH 45440-4461 - Phone
- (479) 201-6091
- NPI assigned
- Apr 3, 2024
- Organization subpart
- No
Authorized official
- Name
- Tracy McCall
- Title
- Credentialing
- Phone
- (479) 201-6091
Other NPIs on the same Medicare enrollment 24
Corporate family (same tax ID) 12
Practitioners 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210621000546 | OH | Part B Supplier - Clinic/Group Practice | 5193036432 |
Receives reassigned benefits from 67 practitioners 24 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Canton, OH; Troy, OH; Toledo, OH; Salem, OH; Rocky River, OH; Perrysburg, OH; Oakwood, OH; Middletown, OH… |
National Provider Directory
- Tax ID family
- Aegis Group Practice
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
280 Walden Way
Dayton, OH 45440-4461
Mailing address
4933 Old Greenwood Rd
Fort Smith, AR 72903-6906
Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2024. 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.