Mattie Devin Elliott, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5164 Issued in SC

Practice address

1801 Old Trolley Rd Ste 203
Summerville, SC 29485-8283

Phone

(843) 594-3032

NPI assigned

Oct 2, 2020

Sex

Female

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Palmetto Hearing Care Center, LLC

  • Speech-Language Pathologist
  • Summerville, SC
  • NPI 1750579561
  NPD (past)

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1831796994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 GATOR TRAK",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294149146",
            "telephone_number": "843-621-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 OLD TROLLEY RD STE 203",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858283",
            "telephone_number": "843-594-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "MATTIE",
        "middle_name": "DEVIN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "5164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Junior Ellerbe II
• Rachel Ellingson, ED.S.
• Yvonne Ellington
• Corinne Elliott, FNP-C
• Kim Marie Elliott
• Melissa Rose Ellis-Yarian, D.O
• Katherine Ellis
• Elodie LLC
• Brian David Elston, PA-C
• Stacie Nettles Elwood, ATC

• Occupational Therapy Assistant in Summerville, SC
• Providers in Summerville, 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 Oct 2, 2020; 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.