Aegis Medical Solutions 1 LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

Legal business name

AEGIS MEDICAL SOLUTIONS 1 LLC

Practice address

1012 Druid Rd E
Clearwater, FL 33756-5606

Phone

(727) 443-4242

Fax

(727) 441-1158

NPI assigned

Feb 19, 2019

Last updated

Feb 19, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ricky P Lockett, D.O.

Title

Medical Director

Phone

(727) 443-4242

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1194281758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 DRUID RD E",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337565606",
            "telephone_number": "727-443-4242",
            "fax_number": "727-441-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 DRUID RD E",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337565606",
            "telephone_number": "727-443-4242",
            "fax_number": "727-441-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEGIS MEDICAL SOLUTIONS 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "LOCKETT",
        "authorized_official_first_name": "RICKY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "727-443-4242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBR",
            "identifier": "OS6109",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.