NPIMap

Organization Active NPI

Aegis Group Practice, LLC

  • Physical Therapist
  • Middleton, WI
National Provider Identifier
1437664935
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
AEGIS GROUP PRACTICE, LLC
Practice address
8301 Old Sauk Rd
Middleton, WI 53562-4389
Phone
(800) 444-6845
Fax
(844) 640-6066
NPI assigned
Dec 6, 2017
Last updated
Dec 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

8301 Old Sauk Rd
Middleton, WI 53562-4389

Mailing address

1000 Fianna Way # Md5740
Fort Smith, AR 72919-9008
Phone (479) 201-6089

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170614002978 WI Part B Supplier - Clinic/Group Practice 5193036432 Receives reassigned benefits from 61 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wisconsin Rapids, WI; West Bend, WI; West Allis, WI; Port Washington, WI; Plymouth, WI; Oshkosh, WI; Hartland, WI; Onalaska, WI…

Other NPIs on the same Medicare enrollment 27

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

View all 27

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512518400000",
    "number": "1437664935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 FIANNA WAY # MD5740",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729199008",
            "telephone_number": "479-201-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 OLD SAUK RD",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535624389",
            "telephone_number": "800-444-6845",
            "fax_number": "844-640-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEGIS GROUP PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "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": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; 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.