Aegis Group Practice LLC
NPI 1417666884ActiveOrganization· Physical Therapist· Green Valley, AZ
Physical Therapist in Green Valley, Arizona, registered in NPPES in November 2022. The authorized official on file is Misty S. Wilson, Contract & Credentialing Specialist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1417666884 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 15, 2022 |
| Last updated in NPPES | Nov 15, 2022 |
| Certified by provider | Nov 15, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
| Speech-Language Pathologist | 235Z00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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