NPIMap

Organization Active NPI

Aegis Group Practice LLC

  • Physical Therapist
  • Rockford, IL
National Provider Identifier
1780553776
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
AEGIS GROUP PRACTICE LLC
Practice address
3470 N Alpine Rd
Rockford, IL 61114-4802
Phone
(815) 877-1441
NPI assigned
Oct 30, 2025
Last updated
Feb 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Terry Lamb
Title
Credentialing
Phone
(479) 201-6037

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

3470 N Alpine Rd
Rockford, IL 61114-4802

Mailing address

4933 Old Greenwood Rd
Fort Smith, AR 72903-6906
Phone (479) 201-6037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221130001868 IL Part B Supplier - Clinic/Group Practice 5193036432 Receives reassigned benefits from 30 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Carmi, IL; Lisle, IL; Rockford, IL

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Aegis Group Practice LLC216 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 6

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1761782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771804800000",
    "number": "1780553776",
    "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": "479-201-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3470 N ALPINE RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611144802",
            "telephone_number": "815-877-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEGIS GROUP PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-30",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A",
        "authorized_official_last_name": "LAMB",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "479-201-6037"
    },
    "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 Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; 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.

Verify at the official NPI Registry.