Individual provider Active NPI

Michael Bryce Bagby, DPT, PT

  • Physical Therapist
  • Myrtle Beach, SC
National Provider Identifier
1790598514
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13300 Issued in SC
Practice address
210 Village Center Blvd Ste 200
Myrtle Beach, SC 29579-6706
Phone
(843) 353-3460
Fax
(843) 353-3461
NPI assigned
Jan 27, 2025
Last updated
Mar 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT61655964 WA
Physical Therapist 225100000X PT2584 WY
Physical Therapist 225100000X 5501303772 MI
Physical Therapist 225100000X 13300 SC Primary

Addresses

Primary practice location

210 Village Center Blvd Ste 200
Myrtle Beach, SC 29579-6706

Mailing address

825 Grosse Pointe CT
Grosse Pointe, MI 48230-1278
Phone (313) 605-9366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250324002130 WA Practitioner - Physical Therapist in Private Practice 3971025529 Reassigns benefits to 2 organizations
I20260522000401 SC Practitioner - Physical Therapist in Private Practice 3971025529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Wayne State University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthosc LLCGroup PAC ID 8022370030, 113 clinicians

Practice addresses (Care Compare)

210 Village Ctr Blvd
Suite 200
Myrtle Beach, SC 29579-6706
Phone (843) 353-3460

945 Hildebrand LN NE
Suite 220
Bainbridge Island, WA 98110-2877
Phone (206) 842-6288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501303772MIMDPhysical Therapist
13300SCMDPhysical Therapist
PT61655964WAMDPhysical Therapist
PT2584WYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Mar 7, 2025 Accepting new patients
Multicare Health System Current Accepting new patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Jul 21, 2025 Accepting new patients
Multicare Health System Physical Therapist CurrentSince Mar 7, 2025 Accepting new patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Jul 21, 2025 Accepting new patients

Locations

945 Hildebrand Ln NE
Ste 220
Bainbridge Island, WA 98110
Phone (206) 842-6288

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

2400 NW Myhre Rd
Ste 101
Silverdale, WA 98383
Phone (360) 598-3764

2400 NW Myhre Rd
Ste 102
Silverdale, WA 98383
Phone (360) 598-3764

19321 Mountain Hwy E
Ste 100
Spanaway, WA 98387
Phone (253) 846-8126

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1790598514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 GROSSE POINTE CT",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482301278",
            "telephone_number": "313-605-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 VILLAGE CENTER BLVD STE 200",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796706",
            "telephone_number": "843-353-3460",
            "fax_number": "843-353-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGBY",
        "first_name": "MICHAEL",
        "middle_name": "BRYCE",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-27",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61655964",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT2584",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303772",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "13300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.