Active NPI
Marivic E Cagampan, PT
- Pediatric Physical Therapist
- Athens, GA
National Provider Identifier
1386664886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 002234
- Practice address
- 1500 Oglethorpe Ave
Athens, GA 30606-2179 - Phone
- (706) 389-2273
- NPI assigned
- Jul 20, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 002234 | Primary |
Addresses
Primary practice location
1500 Oglethorpe Ave
Athens, GA 30606-2179
Mailing address
PO Box 6588
St Marys Home Health Care
Athens, GA 30604-9828
Phone (706) 389-2273
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00839352A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386664886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6588",
"address_2": "ST MARYS HOME HEALTH CARE",
"city": "ATHENS",
"state": "GA",
"postal_code": "306049828",
"telephone_number": "706-389-2273",
"fax_number": "706-208-8883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 OGLETHORPE AVE",
"city": "ATHENS",
"state": "GA",
"postal_code": "306062179",
"telephone_number": "706-389-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAGAMPAN",
"first_name": "MARIVIC",
"middle_name": "E",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": null,
"license": "002234",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00839352A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.