Aegis Group Practice LLC
Organization Active NPI Physical Therapist · Green Bay, WI
NPI 1568049500 · NPPES record last updated Mar 25, 2021
Key facts
- NPI
- 1568049500
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 1740 Condor LN
Green Bay, WI 54313-7776 - Phone
- (800) 444-6845
- Fax
- (479) 478-2852
- NPI assigned
- Mar 25, 2021
- Organization subpart
- No
Authorized official
- Name
- Britt Jeffcoat
- Title
- Senior VP
- Phone
- (972) 372-6799
Other NPIs on the same Medicare enrollment 27
Corporate family (same tax ID) 21
Practitioners 2
-
Sarah Marie Dahl, DPT
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
1740 Condor LN
Green Bay, WI 54313-7776
Mailing address
2601 Network Blvd Ste 102
Frisco, TX 75034-9092
Phone (972) 372-6779
Other providers in Green Bay, WI
- Advanced Physical Therapy & Sports Medicine SC
- Advantage Chiropractic Clinic of Green Bay, S.C.
- Advocates for Healthy Transitional Living, LLC
- Aegis Group Inc
- Aegis Group Inc
- Sara J Aerts
- Affordable Chiropractic.Biz, LLC
- Affordable Dentures & Implants - Green Bay, S.C.
- Susan Kuensli Agard
- Swati Agarwal-Sinha
All providers in Green Bay, 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 Mar 25, 2021. 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.