Aegis Iom, PLLC

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

Legal business name

AEGIS IOM, PLLC

Practice address

5323 E Palomino Rd
Phoenix, AZ 85018-1911

Phone

(702) 670-1588

NPI assigned

May 31, 2018

Organization subpart

No

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

Authorized official

Name

Elise Kilmer

Title

Manager

Phone

(702) 670-1588

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1194217596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41861",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852741861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 E PALOMINO RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850181911",
            "telephone_number": "702-670-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEGIS IOM, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "KILMER",
        "authorized_official_first_name": "ELISE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "702-670-1588"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neurophysiology Physician in Phoenix, AZ
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.