MEDICARE: MICHELLE L CAFFEY P.T.

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1917	NE
2	225100000X	Physical Therapist	03132	IA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1639176506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE L CAFFEY P.T.

Provider Business Mailing Address
First Line	:	PO BOX 3755
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68103-0755
Country	:	US
Telephone Number	:	402-354-2100
Fax Number	:	402-354-2155

Provider Business Practice Location Address
First Line	:	16120 W DODGE RD
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68118-2049
Country	:	US
Telephone Number	:	402-354-0410
Fax Number	:	402-354-0415

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2005
Last Update Date	:	12/31/2013

8200 DODGE STREET , CHILDREN'S HOSPITAL & MEDICARE CENTER
OMAHA, NE
68114-4113

Practice Phone: 402-955-6140
Practice Fax: 402-955-3398