Individual provider Active NPI

Michael Cameron Wilson, PT, DPT

  • Physical Therapist
  • Mount Pleasant, SC
National Provider Identifier
1821528670
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
586 Lone Tree Dr
Mount Pleasant, SC 29464-8170
Phone
(843) 884-7880
Fax
(843) 884-6635
NPI assigned
Jun 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT012925 GA
Physical Therapist 225100000X Primary

Addresses

Primary practice location

586 Lone Tree Dr
Mount Pleasant, SC 29464-8170

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211
Phone (866) 370-8206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180427001730 SC Practitioner - Physical Therapist in Private Practice 8022389139 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.49 of 100Reported as group
Quality
89.43
Improvement activities
40
Cost
74.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Proaxis Therapy LLC CurrentSince May 11, 2023 Accepting new patients
Resilience Physical Therapy Physical Therapist Current Accepting new patients
RSFH - Ati Physical Therapy, LLC Physical Therapist CurrentSince Apr 1, 2018 Accepting new patients
RSFH - Ati Physical Therapy, LLC Physical Therapist CurrentSince Apr 1, 2018 Accepting new patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince May 11, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

33299 Collection Ctr Dr
Chicago, IL 60693

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

1941 Savage Rd
Ste 300A
Charleston, SC 29407
Phone (843) 402-1495

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

4237 River Hills Dr
Ste 120
Little River, SC 29566
Phone (843) 249-5616

4237 River Hills Dr
Ste 110
Little River, SC 29566
Phone (843) 467-8032

586 Lone Tree Dr
Mt Pleasant, SC 29464
Phone (843) 884-7880

8161 Rourk St
Myrtle Beach, SC 29572
Phone (843) 449-3685

5046 Highway 17 Byp S
Ste 201
Myrtle Beach, SC 29588
Phone (843) 668-4329

9241 University Blvd
Ste B1
North Charleston, SC 29406
Phone (843) 414-1140

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1821528670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "866-370-8206",
            "fax_number": "517-435-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 LONE TREE DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294648170",
            "telephone_number": "843-884-7880",
            "fax_number": "843-884-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHAEL",
        "middle_name": "CAMERON",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012925",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; 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.