Active NPI
Aegis Group Practice LLC
- Physical Therapist
- Largo, FL
National Provider Identifier
1659868289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 750 Starkey Rd
Largo, FL 33771-2365 - Phone
- (800) 444-6845
- Fax
- (479) 478-2852
- NPI assigned
- Apr 19, 2018
- Last updated
- Apr 19, 2018
- 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
750 Starkey Rd
Largo, FL 33771-2365
Mailing address
1000 Fianna Way
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": "1524096000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1524096000000",
"number": "1659868289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 FIANNA WAY",
"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": "750 STARKEY RD",
"city": "LARGO",
"state": "FL",
"postal_code": "337712365",
"telephone_number": "800-444-6845",
"fax_number": "479-478-2852"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AEGIS GROUP PRACTICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-04-19",
"last_updated": "2018-04-19",
"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 Largo, FL
- Advanced Surgical Associates of West FL LLP
- Advanced Therapeutic Solutions LLC
- Advanced Urology Institute, LLC
- Advantage Home Assisted Care, Inc.
- Adventure Care PLLC
- Aeshya LLC (Foot Solutions Largo)
- Aeshya LLC (Foot Solutions Largo)
- Aesthetic Center of West Florida LLC (Aesthetic Institute of West Florida)
- Affinity Home Care Inc.
- Affinity Home Medical Equipment
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.