Michelle Caccavo Myers, MPT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

5258 Issued in SC

Practice address

905 Dukes St
Saint George, SC 29477-2059

Phone

(843) 563-4602

NPI assigned

Jun 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Michelle Debra Caccavo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Physical Recovery, LLC

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  • NPI 1598802415

  Geriatrics

  NPD (past)

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417150558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 RIVER LANDING DR",
            "address_2": "#4111",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294927400",
            "telephone_number": "352-246-4371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 DUKES ST",
            "city": "SAINT GEORGE",
            "state": "SC",
            "postal_code": "294772059",
            "telephone_number": "843-563-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "MICHELLE",
        "middle_name": "CACCAVO",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "SC",
            "license": "5258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "CACCAVO",
            "middle_name": "DEBRA",
            "prefix": "MS.",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cynthia McAlhany McClure, APRN
• Kayla McIntire, DPT
• Bridget K Middleton
• Carolyn Olive Mims, CRNA
• Nikiesha Murray, RN
• Orangeburg Family Eye Care, LLC
• Christina Michelle Orosz, PHARMD
• Nathan Henry Page, DC
• Palmetto Primary Care Physicians, LLC (St. George Family Practice)
• Palmetto St. George Operating LLC (St. George Healthcare Center)

• Geriatric Physical Therapist in Saint George, SC
• Providers in Saint George, SC by specialty
• Geriatric Physical Therapist in South Carolina

• 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.

Verify at the official NPI Registry.