Active NPI
Aegis Therapies - Minnesota Rehab LLC
Doing business as Aegis Therapies
- Physical Therapist
- Lake Elmo, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- AEGIS THERAPIES - MINNESOTA REHAB LLC
- Doing business as
- Aegis Therapies
- Practice address
- 192 Jade TRL N
Lake Elmo, MN 55042-4496 - Phone
- (479) 201-6091
- NPI assigned
- May 28, 2013
- Last updated
- Oct 23, 2023
- 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
- Holly Rasmussen-Jones
- Title
- Secretary
- Phone
- (479) 201-4835
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | Primary | |
| Occupational Therapist | 225X00000X | NU | ||
| Speech-Language Pathologist | 235Z00000X | NU |
Addresses
Primary practice location
192 Jade TRL N
Lake Elmo, MN 55042-4496
Mailing address
4933 Old Greenwood Rd
Fort Smith, AR 72903-6906
Phone (479) 201-6147
Other practice location 1
431 Prairie Center Dr
Eden Prairie, MN 55344-5375
Phone (952) 373-0367
Other names 1
- Aegis Therapies
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130801000909 | MN | Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services | 2264673284 | Practice locations: Andover, MN; Woodbury, MN; North Saint Paul, MN; Minneapolis, MN; Maplewood, MN; Lake Elmo, MN; Farmington, MN; Edina, MN… |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1750728077. Details of each certification follow.
Outpatient physical therapy / speech pathology certification: CCN 246607
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- AEGIS THERAPIES - MINNESOTA LLC
- Certification status
- Active
- Provider type (POS)
- Outpatient physical therapy / speech pathology
- Participating since
- Sep 26, 2013
- Last certification
- Sep 26, 2013
- Ownership / control type
- Proprietary
- Facility address
- 431 Prairie Center Drive
Eden Prairie, MN 55344
National Provider Directory
National Provider Directory- Tax ID family
- Aegis Therapies
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Physical Therapist
- Lake Elmo, MN
- NPI 1417729682
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Aegis Medical Supply
- Durable Medical Equipment & Medical Supplies
- Plano, TX
- NPI 1538572870
Member Of
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Occupational Therapist
- Eden Prairie, MN
- NPI 1275183154
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369699200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1698019200000",
"number": "1750728077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4933 OLD GREENWOOD RD",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729036906",
"telephone_number": "479-201-6147",
"fax_number": "479-401-2239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "192 JADE TRL N",
"city": "LAKE ELMO",
"state": "MN",
"postal_code": "550424496",
"telephone_number": "479-201-6091"
}
],
"practiceLocations": [
{
"address_1": "431 Prairie Center Dr",
"address_purpose": "LOCATION",
"city": "Eden Prairie",
"state": "MN",
"postal_code": "553445375",
"country_code": "US",
"telephone_number": "952-373-0367",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "AEGIS THERAPIES - MINNESOTA REHAB LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-05-28",
"last_updated": "2023-10-23",
"certification_date": "2023-10-23",
"status": "A",
"authorized_official_last_name": "RASMUSSEN-JONES",
"authorized_official_first_name": "HOLLY",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "479-201-4835"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Aegis Therapies",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Aegis Therapies",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lake Elmo, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.