Aegis Group Practice LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

AEGIS GROUP PRACTICE LLC

Practice address

325 N Cool Spring St
Fayetteville, NC 28301-5137

Phone

(479) 201-6091

NPI assigned

May 13, 2024

Last updated

May 13, 2024By 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

Tracy McCall

Title

Credentialing

Phone

(479) 201-6091

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

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

• Aegis Group Practice LLC

  • Physical Therapist
  • Raeford, NC
  • NPI 1144081076

  O20220126000987

  Same enrollment
• Aegis Group Practice LLC

  • Physical Therapist
  • Raleigh, NC
  • NPI 1952069536

  O20220126000987

  Same enrollment

Tax ID family

Marguerite Thompson PT211 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

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

• Aegis Group Practice LLC

  • Physical Therapist
  • Raleigh, NC
  • NPI 1952069536
  NPD tax ID

Locations

Practitioners 3

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.

• Mollie Caroline Hoover, OTR/L

  • Occupational Therapist
  • Maxton, NC
  • NPI 1114752482
  NPD
• Nicole Kemerling, OTR

  • Occupational Therapist
  • Fayetteville, NC
  • NPI 1992377329
  NPD
• Kayla Dominque Soriano

  • Physical Therapist
  • Cornelius, NC
  • NPI 1891308581
  NPD

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1942058037",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N COOL SPRING ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283015137",
            "telephone_number": "479-201-6091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEGIS GROUP PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "MCCALL",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "479-201-6091"
    },
    "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": []
}

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• Physical Therapist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.