Active NPI
Elliott Tristan Rodgers, OTR/L
- Occupational Therapist
- Myrtle Beach, SC
National Provider Identifier
1245160134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 7950
- Practice address
- 1129 Bombay LN Unit 8201
Myrtle Beach, SC 29572-4692 - Phone
- (910) 789-4532
- NPI assigned
- May 21, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 7950 | SC | Primary |
Addresses
Primary practice location
1129 Bombay LN Unit 8201
Myrtle Beach, SC 29572-4692
Mailing address
546 Firouz Dr
Longs, SC 29568-6274
Phone (704) 771-8022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7950 | SC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779321600000",
"number": "1245160134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "546 FIROUZ DR",
"city": "LONGS",
"state": "SC",
"postal_code": "295686274",
"telephone_number": "704-771-8022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1129 BOMBAY LN UNIT 8201",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295724692",
"telephone_number": "910-789-4532"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODGERS",
"first_name": "ELLIOTT",
"middle_name": "TRISTAN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-05-21",
"last_updated": "2026-05-21",
"certification_date": "2026-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SC",
"license": "7950",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.