Individual provider Active NPI

Justin Breton, OTR/L

  • Pediatric Occupational Therapist
  • Bluffton, SC
National Provider Identifier
1366480477
Registry record updated Aug 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
6219 Issued in SC
Practice address
16 William Pope Dr Ste 204
Bluffton, SC 29909-7504
Phone
(912) 335-1650
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT8940 FL
Pediatric Occupational Therapist 225XP0200X 6219 SC Primary

Addresses

Primary practice location

16 William Pope Dr Ste 204
Bluffton, SC 29909-7504

Mailing address

2 Moss Creek CT
Hilton Head Island, SC 29926-1100
Phone (352) 262-4835

Other identifiers 1

IdentifierTypeStateIssuer
Z9784OtherFLBCBS OF FLORIDA

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

LicenseStateTypeSpecialty
OT8940FLMDPediatric Occupational Therapist
6219SCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755907200000",
    "number": "1366480477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MOSS CREEK CT",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299261100",
            "telephone_number": "352-262-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WILLIAM POPE DR STE 204",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299097504",
            "telephone_number": "912-335-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRETON",
        "first_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2025-08-23",
        "certification_date": "2025-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT8940",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "SC",
            "license": "6219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "Z9784",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2025; 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.