Active NPI
Aegis Group Practice LLC
- Physical Therapist
- Fairfield, OH
National Provider Identifier
1356915136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 1460 Corydale Dr
Fairfield, OH 45014-3361 - Phone
- (800) 444-6845
- Fax
- (479) 478-2852
- NPI assigned
- May 17, 2021
- Last updated
- May 17, 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) 372-6799
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary | ||
| Occupational Therapist | 225X00000X | |||
| Speech-Language Pathologist | 235Z00000X |
Addresses
Primary practice location
1460 Corydale Dr
Fairfield, OH 45014-3361
Mailing address
2601 Network Blvd Ste 102
Frisco, TX 75034-9092
Phone (972) 372-6779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210621000546 | OH | Part B Supplier - Clinic/Group Practice | 5193036432 |
Receives reassigned benefits from 67 practitioners 24 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Canton, OH; Troy, OH; Toledo, OH; Salem, OH; Rocky River, OH; Perrysburg, OH; Oakwood, OH; Middletown, OH… |
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 DirectoryLocations
2601 Network Blvd
Ste 102
Frisco, TX 75034
Phone (972) 372-6750
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621209600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1621209600000",
"number": "1356915136",
"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",
"telephone_number": "972-372-6779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1460 CORYDALE DR",
"city": "FAIRFIELD",
"state": "OH",
"postal_code": "450143361",
"telephone_number": "800-444-6845",
"fax_number": "479-478-2852"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AEGIS GROUP PRACTICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-17",
"last_updated": "2021-05-17",
"certification_date": "2021-05-17",
"status": "A",
"authorized_official_last_name": "JEFFCOAT",
"authorized_official_first_name": "BRITT",
"authorized_official_title_or_position": "SENIOR VP",
"authorized_official_telephone_number": "972-372-6799"
},
"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 Fairfield, OH
- Brian N. Adkins, P.T.
- Adrian's Wings Home Care LLC
- Eunice Adu
- Adult & Geriatric NP Visits LLC
- Advancing Individuals LLC
- Affilliates in Oral &Maxillofacial Surgery Inc
- Afinia Dental-Killgore Fairfield Inc (Orchard Hill Family Dentistry)
- Vaishali Agarwala, DDS MS
- Alia Nicole Agee, LSW
- Humam H Akbik, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.