Aegis Group Practice LLC

Organization Active NPI Physical Therapist · Ridgeland, MS

NPI 1881271302 · NPPES record last updated Mar 29, 2021

Key facts

NPI
1881271302
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
AEGIS GROUP PRACTICE LLC
Practice address
619 Highland Colony Pkwy
Ridgeland, MS 39157-8786
Phone
(800) 444-6845
Fax
(479) 478-2852
NPI assigned
Mar 29, 2021
Organization subpart
No

Authorized official

Name
Britt Jeffcoat
Title
Senior VP
Phone
(972) 372-6799

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 23

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 404

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 404

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20160126001261 MS Part B Supplier - Clinic/Group Practice 5193036432 Receives reassigned benefits from 20 practitioners
1 other NPI on this enrollment
Practice locations: Ridgeland, MS; Olive Branch, MS

National Provider Directory

Tax ID family
Aegis Group Practice (204 organizations share this tax ID)

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

619 Highland Colony Pkwy
Ridgeland, MS 39157-8786

Mailing address

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

Other providers in Ridgeland, MS

All providers in Ridgeland, MS · Physical Therapist in Mississippi

Sources for this page

Verify at the official NPI Registry.