NPI age
19 years
Enumerated 2006-12-22
● Active
Type 1 · Individual
MR. Michael P Kavanagh, CPO
Kavanagh is 1 of 2 orthotist providers in Fort Moore and 1 of 21 in Georgia.
Primary specialty
Orthotist
Plus 1 subspecialty
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2025-02-04
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 21 active orthotist providers in Georgia.
NPI age
19 years
↑ 4 yr above median (15 yr)
State licenses
1 state
0% of peers hold multiple states
Subspecialties
1
In the 38% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-12Enumerated in NPPES
2006
2026
Where they practice
Practice location
6600 Van Aalst Blvd
Fort Moore, GA 319052102
Mailing address
125 Perrys Mill Rd
Pine Mountain, GA 318225112
Additional practice locations
1 secondary location on file with NPPES.
Location 2
125 Perry Mill Rd
Pine Mountain, GA 318225112
Specialties
-
Orthotist PrimaryA 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...
-
ProsthetistA 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,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 836804665A |
Practice context
Part of a multi-provider practice. 115 other active providers share this practice address in NPPES.
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