NPIMap

Organization Active NPI

Aegis Idaho LLC

Doing business as Aegis Home Health and Hospice

  • Community Based Hospice Care Agency
  • Preston, ID
National Provider Identifier
1215756952
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
AEGIS IDAHO LLC
Doing business as
Aegis Home Health and Hospice
Practice address
30 N State St
Preston, ID 83263-1237
Phone
(435) 723-9000
Fax
(435) 734-9819
NPI assigned
Oct 9, 2024
Last updated
Oct 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Authorized official

Name
Gregory Chad Mangum, RN
Title
Ceo
Phone
(435) 723-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

30 N State St
Preston, ID 83263-1237

Mailing address

30 N State St
Preston, ID 83263-1237
Phone (435) 723-9000

Other names 1

  • Aegis Home Health and Hospice Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Aegis Home Health and Hospice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1215756952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N STATE ST",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832631237",
            "telephone_number": "435-723-9000",
            "fax_number": "435-734-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N STATE ST",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832631237",
            "telephone_number": "435-723-9000",
            "fax_number": "435-734-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEGIS IDAHO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "MANGUM",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "CHAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "435-723-9000",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aegis Home Health and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Preston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.