Aegis Group Practice, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

AEGIS GROUP PRACTICE, LLC

Practice address

1306 Pelham Rd
Greenville, SC 29615-3600

Phone

(800) 444-6845

NPI assigned

Aug 21, 2020

Last updated

Aug 21, 2020By the provider in NPPES

Organization subpart

No

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

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

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

• Aegis Group Practice LLC

  • Physical Therapist
  • Greenville, SC
  • NPI 1063230704

  O20200911000933

  Same enrollment
• Aegis Group Practice LLC

  • Physical Therapist
  • Anderson, SC
  • NPI 1144981549

  O20200911000933

  Same enrollment
• Aegis Group Practice LLC

  • Physical Therapist
  • Aiken, SC
  • NPI 1760341382

  O20200911000933

  Same enrollment
• Aegis Group Practice LLC

  • Physical Therapist
  • Anderson, SC
  • NPI 1891446043

  O20200911000933

  Same enrollment

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597968000000",
    "number": "1821600735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 NETWORK BLVD STE 102",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750349092",
            "telephone_number": "972-372-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 PELHAM RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153600",
            "telephone_number": "800-444-6845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEGIS GROUP PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-21",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Greenville, SC
• Providers in Greenville, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; 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.