Active NPI
Aegis Group Practice LLC
- Physical Therapist
- Woodstock, GA
National Provider Identifier
1215512173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 13682 Highway 92
Woodstock, GA 30188-4558 - Phone
- (770) 674-0937
- Fax
- (479) 401-2171
- NPI assigned
- Mar 12, 2021
- Last updated
- Mar 12, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Britt Jeffcoat
- Title
- Senior VP
- Phone
- (972) 372-6779
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | Primary | |
| Occupational Therapist | 225X00000X | NU | ||
| Speech-Language Pathologist | 235Z00000X | NU |
Addresses
Primary practice location
13682 Highway 92
Woodstock, GA 30188-4558
Mailing address
2601 Network Blvd Ste 102
Frisco, TX 75034-9092
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
Other NPIs on the same Medicare enrollment 37
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615507200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1615507200000",
"number": "1215512173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2601 NETWORK BLVD STE 102",
"city": "FRISCO",
"state": "TX",
"postal_code": "750349092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13682 HIGHWAY 92",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301884558",
"telephone_number": "770-674-0937",
"fax_number": "479-401-2171"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AEGIS GROUP PRACTICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-03-12",
"last_updated": "2021-03-12",
"certification_date": "2021-02-22",
"status": "A",
"authorized_official_last_name": "JEFFCOAT",
"authorized_official_first_name": "BRITT",
"authorized_official_title_or_position": "SENIOR VP",
"authorized_official_telephone_number": "972-372-6779"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, GA
- Advanced Gastroenterology Group
- Advanced Health Solutions, LLC
- Advanced Pain & Spine Center
- Advanced Therapy Solutions
- Advent Counseling and Training (acts)
- Aegis Group Practice, LLC
- Afc Physicians of Georgia, PC
- Agape Chronic Care, LLC
- Agape Hospice Care of Cherokee County, LLC (Agape Hospice Care)
- Agape Recovery House LLC (Inner Voyage Recovery Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.