Aegis Group Practice, LLC

Organization Active NPI Physical Therapist · Greenville, SC

NPI 1821600735 · NPPES record last updated Aug 21, 2020

Key facts

NPI
1821600735
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 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
Organization subpart
No

Authorized official

Name
Michael McOlvin
Title
VP-Finance
Phone
(479) 201-2000

Other NPIs on the same Medicare enrollment 4

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200911000933 SC Part B Supplier - Clinic/Group Practice 5193036432 Receives reassigned benefits from 6 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Anderson, SC; Greenville, SC; Aiken, SC

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225100000X Yes
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225X00000X
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP
235Z00000X

Addresses

Primary practice location

1306 Pelham Rd
Greenville, SC 29615-3600

Mailing address

2601 Network Blvd Ste 102
Frisco, TX 75034-9092
Phone (972) 372-6779

Other providers in Greenville, SC

All providers in Greenville, SC · Physical Therapist in South Carolina

Sources for this page

Verify at the official NPI Registry.