Aegis Group Practice LLC
NPI 1639885379ActiveOrganization· Physical Therapist· Zimmerman, MN
Physical Therapist in Zimmerman, Minnesota, registered in NPPES in January 2023. The authorized official on file is Misty S. Wilson, Contract & Credentialing Specialist.
Overview
| NPI | 1639885379 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 26, 2023 |
| Last updated in NPPES | Jan 26, 2023 |
| Certified by provider | Jan 26, 2023 |
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 · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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