Hillary Coulbourne, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5114 Issued in SC

Practice address

580 Robert Daniel Dr
Daniel Island, SC 29492-7448

Phone

(843) 765-2804

NPI assigned

May 19, 2021

Last updated

May 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1194399634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 MILLDAM PASS",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294558250",
            "telephone_number": "410-310-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 ROBERT DANIEL DR",
            "city": "DANIEL ISLAND",
            "state": "SC",
            "postal_code": "294927448",
            "telephone_number": "843-765-2804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Robertson Blvd",
            "address_purpose": "LOCATION",
            "city": "Walterboro",
            "state": "SC",
            "postal_code": "294882787",
            "country_code": "US",
            "telephone_number": "843-782-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COULBOURNE",
        "first_name": "HILLARY",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "5114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Church DMD LLC
• Heidi L Clower, MS/CCC-A
• Ann Coble, LD
• Thomas Compagna
• Colleen Ann Corcoran, RN BSN
• William M Cramer
• Carole Reese Cunningham, RN
• Darin W Cunningham
• Daniel Island Dentistry, LLC
• Daniel Island Family Care

• Occupational Therapy Assistant in Daniel Island, SC
• Providers in Daniel Island, SC by specialty
• Occupational Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.