NPIMap

Organization Active NPI

Aegis Physical Therapy Inc. PS

  • Physical Therapy Clinic/Center
  • Yakima, WA
National Provider Identifier
1437330339
Registry record updated May 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT00010836 Issued in WA
Legal business name
AEGIS PHYSICAL THERAPY INC. PS
Practice address
3901 Kern Way
Suite 102
Yakima, WA 98902-7804
Phone
(509) 895-7449
Fax
(509) 895-7452
NPI assigned
Nov 19, 2007
Last updated
May 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2009

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

Authorized official

Name
Mr. Leonard Merlin Galloway, MPTNPI 1033149869
Title
Owner
Phone
(509) 895-7449

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT00010836 WA Primary

Addresses

Primary practice location

3901 Kern Way
Suite 102
Yakima, WA 98902-7804

Mailing address

PO Box 2721
Yakima, WA 98907-2721
Phone (509) 895-7449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080305000575 WA Part B Supplier - Clinic/Group Practice 6305921040 Receives reassigned benefits from 2 practitioners
Practice locations: Yakima, WA

National Provider Directory

National Provider Directory

Locations

3901 Kern Rd
Ste 102
Yakima, WA 98902
Phone (509) 895-7449

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1437330339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2721",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989072721",
            "telephone_number": "509-895-7449",
            "fax_number": "509-895-7452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 KERN WAY",
            "address_2": "SUITE 102",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027804",
            "telephone_number": "509-895-7449",
            "fax_number": "509-895-7452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEGIS PHYSICAL THERAPY INC. PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "GALLOWAY",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "MERLIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-895-7449",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WA",
            "license": "PT00010836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; 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.

Verify at the official NPI Registry.