Aegis Group Practice LLC
Organization Active NPI Physical Therapist · Covington, TN
NPI 1538046693 · NPPES record last updated Aug 20, 2025
Key facts
- NPI
- 1538046693
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 805 Bert Johnston Ave
Covington, TN 38019-2444 - Phone
- (479) 201-6091
- NPI assigned
- Aug 20, 2025
- Organization subpart
- No
Authorized official
- Name
- Tracy McCall
- Title
- Credentialing
- Phone
- (479) 201-6091
Other NPIs on the same Medicare enrollment 22
Corporate family (same tax ID) 16
Practitioners 2
-
Cliff Thompson Roberts, OTR/L
-
Leigh Smith, PT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231018002544 | TN | Part B Supplier - Clinic/Group Practice | 5193036432 |
Receives reassigned benefits from 93 practitioners 22 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lexington, TN; Memphis, TN; Milan, TN; Somerville, TN; Jackson, TN; Collierville, TN; Cordova, TN; Dyersburg, TN… |
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
805 Bert Johnston Ave
Covington, TN 38019-2444
Mailing address
4933 Old Greenwood Rd
Fort Smith, AR 72903-6906
Phone (479) 201-6091
Other providers in Covington, TN
- A. Roy Wrather, D.D.S.
- Abf Inc
- Demetrice Adams
- Michelle L Allen
- Alliance Obstetrics & Gynecology
- Desarae Jean Anderson
- Rebecca G Archer
- Armour Family Medicine, PLLC
All providers in Covington, TN · Physical Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2025. 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.