AEGIS GROUP PRACTICE, LLC (NPI# 1700384021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700384021 |
| Entity Type | Organization |
| Organization Name | AEGIS GROUP PRACTICE, LLC |
| Practice Address |
12350 San Jose Blvd Jacksonville FL 32223-2641 |
| Mailing Address |
1000 Fianna Way Fort Smith AR 72919-9008 |
| Practice Telephone | 8004446845 |
| Mailing Telephone | 4792016089 |
| Mailing Fax Number | 4799352970 |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2018-02-01 |
| Authorized Official Name | MICHAEL MCOLVIN (VP - FINANCE) |
| Authorized Official Telephone | 4792012000 |
| Is Organization Subpart | N |
| 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 |
12350 SAN JOSE BLVD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32223-2641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184038010 | Kelli Anne Cabrera | Occupational Therapist | 12350 San Jose Blvd, Jacksonville, FL 32223 | 2014-06-18 |
| 1588203186 | Ariel Grieve | Occupational Therapist | 12350 San Jose Blvd, Jacksonville, FL 32223-2800 | 2019-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679103600 | Karen Gabriela Alexander | Dietitian, Registered | Ackerman Cancer Center, 10881 San Jose Blvd, Jacksonville, FL 32223 | 2020-01-17 |
| 1891250049 | Thalia L Honea | Occupational Therapist | 12766 San Jose Blvd, Suite 716 & 717, Jacksonville, FL 32223 | 2019-02-01 |
| 1447758289 | Stephanie Ann Murphy | Marriage & Family Therapist | 11543 Halethorpe Drive, Jacksonville, FL 32223 | 2018-01-26 |
| 1861948481 | Nicole Gay | Developmental Therapist | 12276 San Jose Blvd, Ste 5, Jacksonville, FL 32223 | 2016-09-01 |
| 1740694439 | Robyn K Mizelle | Behavioral Analyst | 12276 San Jose Blvd. Great Strides Rehabilitation, Suite 507, Jacksonville, FL 32223 | 2014-06-20 |
| 1891031910 | Mandarin Family Medicine, P.a. | Preferred Provider Organization | 12276-210 San Jose Blvd, Jacksonville, FL 32223 | 2012-12-18 |
| 1114201811 | Darshana Choksi | Pharmacist | 3663 Marbon Rd, Jacksonville, FL 32223 | 2011-09-30 |
| 1346539988 | Harris Wilcox and Donovan Pa | Optometrist | 11790 San Jose Bl, Jacksonville, FL 32223 | 2011-04-05 |
| 1740517796 | Beth A. Kelley | Occupational Therapist | 2640 Scott Mill Dr, Jacksonville, FL 32223 | 2009-11-12 |
| 1760664759 | Katherine Ann Regan | Speech-Language Pathologist | 2676 Tacito Trail, Jacksonville, FL 32223 | 2007-11-30 |
| Find all providers in zip 32223 | ||||
| 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 |
|---|---|---|---|---|
| 1467050245 | Abigail Faith Moore | Occupational Therapist | 708 Christopher Ct, Jacksonville, NC 28546-5849 | 2020-10-13 |
| 1093324923 | Leigh Ann Curette | Occupational Therapist | 7833 Blackstone River Dr E, Jacksonville, FL 32256-2993 | 2020-07-27 |
| 1992331151 | Jerelyne De Castro Idica | Occupational Therapist | 7801 Point Meadows Dr Unit 1102, Jacksonville, FL 32256-9134 | 2020-03-19 |
| 1265087332 | Thatiana M Howard | Occupational Therapist | 761 Village Center Dr S Apt 227, Jacksonville, FL 32206-1895 | 2019-08-06 |
| 1598310856 | T'erra Dale | Occupational Therapist | 11548 Willet Ct N, Jacksonville, FL 32225-3516 | 2019-08-05 |
| 1710541552 | Kiley Throop | Occupational Therapist | 200 Valencia Dr Ste 160, Jacksonville, NC 28546-6315 | 2019-04-26 |
| 1467912063 | Jacksonville Orthopaedic Institute Inc | Occupational Therapist | 14534 Old Saint Augustine Rd Ste 3220, Jacksonville, FL 32258-2460 | 2019-03-21 |
| 1184181000 | Jeremy Klimek | Occupational Therapist | 910 Assisi Lane, Jacksonville, FL 32233 | 2019-02-27 |
| 1528523917 | Mylee Gamboa | Occupational Therapist | 1334 Iralou Rd, Jacksonville, FL 32254-2224 | 2019-02-10 |
| 1891250049 | Thalia L Honea | Occupational Therapist | 12766 San Jose Blvd, Suite 716 & 717, Jacksonville, FL 32223 | 2019-02-01 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32223 |
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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.