Active NPI
Aegis Group Practice LLC
- Physical Therapist
- Hollywood, FL
National Provider Identifier
1518477140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 1200 Arthur St
Hollywood, FL 33019-3118 - Phone
- (800) 444-6845
- Fax
- (844) 640-6066
- NPI assigned
- Oct 10, 2017
- Last updated
- Oct 10, 2017
- 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
1200 Arthur St
Hollywood, FL 33019-3118
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 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": "1507593600000",
"number": "1518477140",
"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": "1200 ARTHUR ST",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330193118",
"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": "2017-10-10",
"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 Hollywood, FL
- Advanced Institute of Obstetrics and Gynecology of South Florida
- Advanced Medical Research Group, Inc.
- Advanced Prosthetics of America Inc (Hanger Clinic)
- Advanced Psychiatric Services Professional Association
- Sarah Aeder, RN
- Aegis Group Practice, LLC
- Aesthetic Medical Academy USA Inc
- Afc Medical Devices LLC
- Mesfin Afework, MD
- Affiliated Pediatrics of South Florida LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.