Aegis Group Practice LLC
Organization Active NPI Physical Therapist · Mansfield, OH
NPI 1093389751 · NPPES record last updated May 18, 2021
Key facts
- NPI
- 1093389751
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 1296 S Trimble Rd
Mansfield, OH 44906-2970 - Phone
- (800) 444-6845
- NPI assigned
- May 18, 2021
- Organization subpart
- No
Authorized official
- Name
- Britt Jeffcoat
- Title
- Senior VP
- Phone
- (972) 372-6799
Other NPIs on the same Medicare enrollment 24
Other NPIs with the same Medicare PAC ID 23
Corporate family (same tax ID) 13
Practitioners 424
-
Michelle Baker, PT
-
Elizabeth Harvey Baldwin, OTR/L
-
Kaitlin Bigner, CCC-SLP
-
Amanda Marie Bolgar, OTR/L
-
Jennifer L Botchick, MOT, OTR/L
-
Ashley Define, SLP
-
Alicia Erin Gottfried, MOT, OTR/L
-
Jamie Hornick, DPT
-
Ashly Hulin, SLP
-
Geralynn A Hussell, MA-CCC-SLP
-
Sandra Kristine Koch, PT,DPT
-
Alexis Lee, OTR/L
-
Debora L Livengood, CCC-SLP
-
Jennifer Lynn Mazzaro, OTR/L
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 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
Locations
501 Chardon Windsor Rd
Chardon, OH 44024
Phone (440) 286-2277
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
1296 S Trimble Rd
Mansfield, OH 44906-2970
Mailing address
2601 Network Blvd Ste 102
Frisco, TX 75034-9092
Phone (972) 372-6779
Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 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.