Aegis Group Practice LLC
Organization Active NPI Physical Therapist · Niceville, FL
NPI 1669976015 · NPPES record last updated Mar 21, 2018
Key facts
- NPI
- 1669976015
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 2300 Partin Dr N
Niceville, FL 32578-1538 - Phone
- (800) 444-6845
- NPI assigned
- Mar 21, 2018
- Organization subpart
- No
Authorized official
- Name
- Michael McOlvin
- Title
- VP-Finance
- Phone
- (479) 201-2000
Other NPIs on the same Medicare enrollment 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| 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 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
2300 Partin Dr N
Niceville, FL 32578-1538
Mailing address
1000 Fianna Way
Fort Smith, AR 72919-9008
Phone (479) 201-6089
Other providers in Niceville, FL
- Acumen Health PLLC
- Susan Marie Adamov
- Shari Adams
- Lorie A Adelmann
- Lauren F Adkinson
- Afc Florida, LLC
- Aileen T. Playter, LLC
- Oseremen Aiworia
- Kyllian Aldridge
- Kyara Lee Alejandro-Reyes
All providers in Niceville, FL · Physical Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2018. 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.