AEGIS GROUP PRACTICE, LLC (NPI# 1275073363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275073363 |
| Entity Type | Organization |
| Organization Name | AEGIS GROUP PRACTICE, LLC |
| Practice Address |
W129n6889 Northfield Dr Menomonee Falls WI 53051-0518 |
| Mailing Address |
1000 Fianna Way # Md4843 Fort Smith AR 72919-9008 |
| Practice Telephone | 4792012000 |
| Practice Fax Number | 4792014801 |
| Mailing Telephone | 4792012000 |
| Mailing Fax Number | 4792014801 |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2017-03-08 |
| Authorized Official Name | MIKE MCOLVIN (DIRECTOR) |
| Authorized Official Telephone | 4792012000 |
| Is Organization Subpart | Y |
| Parent Organization Name | AEGIS THERAPIES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124527189 | Aegis Group Practice, LLC | Physical Therapist | 2500 Aaron Street, Port Charlotte, FL 33952 | 2018-02-06 |
| 1841705985 | Aegis Group Practice, LLC | Occupational Therapist | 4401 Shallowford Rd Ste 158, Roswell, GA 30075-3175 | 2017-12-12 |
| 1063927879 | Aegis Group Practice, LLC | Occupational Therapist | 999 Crosswater Pkwy, Ponte Vedra, FL 32081-0891 | 2017-12-04 |
| 1841731569 | Aegis Group Practice, LLC | Physical Therapist | 3385 Trickum Rd, Woodstock, GA 30188-4234 | 2017-03-14 |
| 1538600226 | Aegis Group Practice, LLC | Physical Therapist | 2100 Johnston Dr, Raymore, MO 64083-8122 | 2017-03-14 |
| 1518408244 | Aegis Group Practice, LLC | Speech-Language Pathologist | 201 Evergreen Ter, Stockbridge, GA 30281-7375 | 2017-03-14 |
| 1720529423 | Aegis Group Practice, LLC | Physical Therapist | 7155 S Dearing Rd, Covington, GA 30014-7002 | 2017-03-14 |
| 1750822466 | Aegis Group Practice, LLC | Physical Therapist | 1701 Nw Jefferson St, Blue Springs, MO 64015-7229 | 2017-03-14 |
| 1538600259 | Aegis Group Practice, LLC | Physical Therapist | 4999 Prestley Mill Rd, Douglasville, GA 30135-1463 | 2017-03-14 |
| 1548700610 | Aegis Group Practice, LLC | Physical Therapist | 35 1st Ave N, Waite Park, MN 56387-1225 | 2017-03-08 |
| Street Address |
W129N6889 NORTHFIELD DR |
| City | MENOMONEE FALLS |
| State | WI |
| Zip Code | 53051-0518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033697495 | Erin Christen | Physical Therapist | W129n6889 Northfield Dr, Menomonee Falls, WI 53051-0518 | 2018-07-29 |
| 1841782596 | Kristine Johnson | Physical Therapist | W129n6889 Northfield Dr, Menomonee Falls, WI 53051-0518 | 2018-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356968002 | Marisa Hiley | Nurse Practitioner | W129 N7055 Northfield Drive, Menomonee Falls, WI 53051 | 2020-06-29 |
| 1225687940 | Andres Sercovich | Pharmacist | W12501 Leatherwood Ct N74, Menomonee Falls, WI 53051 | 2019-09-05 |
| 1699329193 | Athletico Ltd | Physical Therapist | N88w15562 Main St, Menomonee Falls, WI 53051 | 2019-08-01 |
| 1386103059 | Aegis Group Practice LLC | Occupational Therapist | N48w14250 W Hampton Ave, Menomonee Falls, WI 53051 | 2019-03-13 |
| 1962969220 | Paladina Health, LLC | Family Medicine | Paladina Health Menomonee Falls, N84 W15787 Menomonee Avenue Suite 6, Menomonee Falls, WI 53051 | 2019-02-22 |
| 1053814772 | Waukesha County Community Dental Clinic, Inc. | Clinic/Center | N81w15062 Appleton Ave, Menomonee Falls, WI 53051 | 2018-03-09 |
| 1942753314 | Kelly Schmidt | Pharmacist | 200 Woodland Prime Ste 300, Menomonee Falls, WI 53051 | 2016-08-02 |
| 1386027548 | Generations Family Dental Care Menomonee Falls, LLC | Dentist | N48 W14170 Hampton Ave., Menomonee Falls, WI 53051 | 2015-07-07 |
| 1184007551 | Monjot Kaur Kang | Pharmacist | N82 W15882 Appleton Ave, Menomonee Falls, WI 53051 | 2015-07-03 |
| 1417334038 | Costco Wholesale Corporation | Hearing Aid Equipment | 9235 Pershing Avenue, Menomonee Falls, WI 53051 | 2015-05-04 |
| Find all providers in zip 53051 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386103059 | Aegis Group Practice LLC | Occupational Therapist | N48w14250 W Hampton Ave, Menomonee Falls, WI 53051 | 2019-03-13 |
| 1740795707 | Sarah Latendresse | Occupational Therapist | W156n9000 Pilgrim Rd # I, Menomonee Falls, WI 53051-2272 | 2017-12-12 |
| 1194181172 | Tierra Johnson | Occupational Therapist | N83w13696 Fndulc Ave, Menomonee Falls, WI 53051-7277 | 2016-01-06 |
| 1588923627 | Patricia Ann Anton | Occupational Therapist | N64w14465 Mill Rd, Menomonee Falls, WI 53051-5147 | 2012-05-10 |
| 1003174087 | Paxxon Healthcare Services LLC | Occupational Therapist | W180n7890 Town Hall Rd, Menomonee Falls, WI 53051-4050 | 2012-04-27 |
| 1952545733 | Michelle Marie Bollig | Occupational Therapist | N180 W7890 Town Hall Road, Menomonee Falls, WI 53051 | 2009-04-24 |
| 1326294794 | Erin B. Kosolcharoen | Occupational Therapist | N61w14539 Brookside Dr, Menomonee Falls, WI 53051-5881 | 2008-08-17 |
| 1528274826 | Kathy J. Bonesho | Occupational Therapist | N79w14749 Appleton Ave, Suite C, Menomonee Falls, WI 53051-4375 | 2007-05-15 |
| 1124083910 | Matthew Plach | Occupational Therapist | W178n9201 Water Tower Pl, Menomonee Falls, WI 53051-8029 | 2006-04-18 |
| 1598275190 | Lauren Britt | Occupational Therapist | W180n8071 Town Hall Rd, Menomonee Falls, WI 53051-3518 | 2017-10-09 |
| Find all providers in MENOMONEE FALLS | ||||
| City | MENOMONEE FALLS |
| Zip Code | 53051 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.