Aegis Group Practice LLC

Organization Active NPI Physical Therapist · Cordova, TN

NPI 1215712781 · NPPES record last updated Aug 31, 2023

Key facts

NPI
1215712781
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
AEGIS GROUP PRACTICE LLC
Practice address
1535 Appling Care LN
Cordova, TN 38016-4994
Phone
(800) 444-6845
NPI assigned
Aug 31, 2023
Organization subpart
No

Authorized official

Name
Tracy McCall
Title
Contract Specialist
Phone
(479) 201-6091

Other NPIs on the same Medicare enrollment 22

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 16

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20231018002544 TN Part B Supplier - Clinic/Group Practice 5193036432 Receives reassigned benefits from 93 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lexington, TN; Memphis, TN; Milan, TN; Somerville, TN; Jackson, TN; Collierville, TN; Cordova, TN; Dyersburg, TN…

National Provider Directory

Tax ID family
Aegis Group Practice (204 organizations share this tax ID)

Locations

6300 Briarcrest Ave
Memphis, TN 38120
Phone (901) 386-3211

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225100000X Yes
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225X00000X
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP
235Z00000X

Addresses

Primary practice location

1535 Appling Care LN
Cordova, TN 38016-4994

Mailing address

4933 Old Greenwood Rd
Fort Smith, AR 72903-6906

Other providers in Cordova, TN

All providers in Cordova, TN · Physical Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.