Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1619032497 Individual Practitioner Male Practitioner

Michael P Kavanagh , CPO

Orthotist • Fort Moore, GA

Professional Overview & Biography Verified Profile Summary

Michael Kavanagh, CPO is a registered healthcare professional specializing in Orthotist in Fort Moore, GA. Practice services are available at 6600 VAN AALST BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

6600 Van Aalst Blvd

Fort Moore, GA 319052102

Telephone 7624081467

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthotist in Fort Moore, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
2 Specialists

Practicing in Fort Moore, GA (21 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-02-04
Orthotist Primary Specialty

NUCC Taxonomy Code: 222Z00000X

State License GA 34

A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.

Prosthetist

NUCC Taxonomy Code: 224P00000X

State License GA 34

A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
836804665A (GA)

Secondary Practice Locations

125 Perry Mill Rd

Pine Mountain, GA 318225112

Phone: 7703284158

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Wendy Rowell

Orthotist

NPI 1184490948

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location February 04, 2025

Registered at 6600 VAN AALST BLVD, FORT MOORE, GA 319052102 (Tel: 7624081467)

📍
Updated Practice Location September 17, 2019

Registered at 6600 VAN AALST BLVD, FORT BENNING, GA 319052102 (Tel: 7624081467)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 17, 2019

Prosthetist (License #34 in GA)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 1485 HIGHWAY 34 EAST, SUITE 15, NEWNAN, GA 30265 (Tel: 7706834870)

📍
Updated Business Mailing Address July 08, 2007

Registered at 125 PERRYS MILL RD, PINE MOUNTAIN, GA 318225112 (Tel: 7066639715)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as MICHAEL KAVANAGH, CPO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Orthotist

🟢
Initial NPI Registration & Enumeration December 22, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1619032497
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 22, 2006
Last Update: February 04, 2025
Sole Proprietor: No

Mailing Address

125 Perrys Mill Rd

Pine Mountain, GA 318225112

Phone: 7066639715

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.