Carolyn Burke Ellis

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

3651 Issued in SC

Practice address

3620 Happy Woods CT
Myrtle Beach, SC 29588-2925

Phone

(843) 457-7624

NPI assigned

Jul 10, 2017

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

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499644800000",
    "number": "1508388703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 REEF RUN RD",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295857146",
            "telephone_number": "843-957-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 HAPPY WOODS CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295882925",
            "telephone_number": "843-457-7624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE ELLIS",
        "first_name": "CAROLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2017-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "3651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan M Bulsza, LPC
• Thomas Bumbalo, MD
• Donna Lynn Burchell, PTA
• Amy Harrelson Burchette, REGISTERED NURSE
• La'Asha Burgess, PA
• Zachary James Burkett, CHIROPRACTOR DC
• Cameron Burr, DO
• Theresa Faye Burton, LPN
• Nicholas Alexander Buskill, DO
• Christopher Francis Buthorn, RPA-C

• Occupational Therapy Assistant in Myrtle Beach, SC
• Providers in Myrtle Beach, 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 Jul 10, 2017; 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.