Active NPI
Aegis Group Practice LLC
- Physical Therapist
- Naples, FL
National Provider Identifier
1265942890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 2626 Goodlette Frank Rd
Naples, FL 34103-4526 - Phone
- (800) 444-6845
- Fax
- (844) 640-6066
- NPI assigned
- Oct 10, 2017
- Last updated
- Apr 19, 2022
- 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
- Michael McOlvin
- Title
- VP-Finance
- Phone
- (479) 201-2000
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary | ||
| Occupational Therapist | 225X00000X | |||
| Speech-Language Pathologist | 235Z00000X |
Addresses
Primary practice location
2626 Goodlette Frank Rd
Naples, FL 34103-4526
Mailing address
4933 Old Greenwood Rd
Fort Smith, AR 72903-6906
Phone (479) 201-6147
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170720002185 | FL | Part B Supplier - Clinic/Group Practice | 5193036432 |
Receives reassigned benefits from 17 practitioners 24 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Indian Harbour Beach, FL; Pensacola, FL |
Other NPIs on the same Medicare enrollment 24
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": "1507593600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1650326400000",
"number": "1265942890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4933 OLD GREENWOOD RD",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729036906",
"telephone_number": "479-201-6147",
"fax_number": "479-401-2239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2626 GOODLETTE FRANK RD",
"city": "NAPLES",
"state": "FL",
"postal_code": "341034526",
"telephone_number": "800-444-6845",
"fax_number": "844-640-6066"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AEGIS GROUP PRACTICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-10-10",
"last_updated": "2022-04-19",
"certification_date": "2022-04-19",
"status": "A",
"authorized_official_last_name": "MCOLVIN",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "VP-FINANCE",
"authorized_official_telephone_number": "479-201-2000"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.