Individual provider Active NPI

Christopher Cacciatore, DO

  • Emergency Medicine Physician
  • Greenville, SC
National Provider Identifier
1073364378
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
LL91492 Issued in SC
Practice address
876 W Faris Rd
Greenville, SC 29605-4253
Phone
(864) 455-5648
NPI assigned
Mar 27, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X LL91492 SC Primary

Addresses

Primary practice location

876 W Faris Rd
Greenville, SC 29605-4253

Mailing address

876 W Faris Rd
Greenville, SC 29605-4253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241008002552 SC Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 2264963727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1073364378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "876 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "876 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054253",
            "telephone_number": "864-455-5648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACCIATORE",
        "first_name": "CHRISTOPHER",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "LL91492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.