Aegis Group Practice LLC
Organization Active NPI Physical Therapist · Middleton, WI
NPI 1467097360 · NPPES record last updated Nov 14, 2019
Key facts
- NPI
- 1467097360
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 6234 Maywood Ave
Middleton, WI 53562-2205 - Phone
- (800) 444-6845
- NPI assigned
- Nov 14, 2019
- Organization subpart
- No
Authorized official
- Name
- Michael McOlvin
- Title
- VP-Finance
- Phone
- (479) 201-2000
Other NPIs on the same Medicare enrollment 27
Corporate family (same tax ID) 23
Practitioners 4
-
Megan Fitch, OTR/L
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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… |
National Provider Directory
- Tax ID family
- Aegis Group Practice
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
6234 Maywood Ave
Middleton, WI 53562-2205
Mailing address
2601 Network Blvd Ste 102
Frisco, TX 75034-9092
Phone (972) 372-6779
Other providers in Middleton, WI
- Actualize Counseling & Consulting, LLC
- Ruby A. Adams-Stevenson
- Adio Chiropractic, LLC
- Advance Cable Company LLC
- Aegis Group Practice LLC
- Aegis Group Practice, LLC
- Jo Ann M Ahles
- Jesse C Albright
- Joan K Albright
- Emily Jo Alcott
All providers in Middleton, WI · Physical Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.