Aegis Group Practice LLC
Organization Active NPI Physical Therapist · Little Falls, MN
NPI 1972197382 · NPPES record last updated Mar 10, 2022
Key facts
- NPI
- 1972197382
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 1012 3Rd Ave NE
Little Falls, MN 56345-4647 - Phone
- (800) 444-6845
- NPI assigned
- Feb 25, 2021
- Organization subpart
- No
Authorized official
- Name
- Britt Jeffcoat
- Title
- Senior VP
- Phone
- (972) 372-6799
Other NPIs on the same Medicare enrollment 33
Corporate family (same tax ID) 14
Practitioners 2
-
Manda Florence Riebel, MA, CCC-SLP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150612001586 | MN | Part B Supplier - Clinic/Group Practice | 5193036432 |
Receives reassigned benefits from 71 practitioners 33 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Rogers, MN; Zimmerman, MN; Willmar, MN; White Bear Lake, MN; Shakopee, MN; Savage, MN; Sartell, MN; Saint Michael, MN… |
National Provider Directory
- Tax ID family
- Aegis Group Practice
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
1012 3Rd Ave NE
Little Falls, MN 56345-4647
Mailing address
4933 Old Greenwood Rd
Fort Smith, AR 72903-6906
Phone (479) 201-6123
Other providers in Little Falls, MN
- A Willow Bends LLC
- Kimberly Kristy Acker
- Deann Lynn Adams
- Advance Physical Therapy Inc.
- Allison Zak, D.C., LLC
- Gregory J Anderson
- Jenna Catherine Anderson
- Kathleen Mary Anderson
- Emily Appel
All providers in Little Falls, MN · Physical Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.