Brent Earl Parker Jr., ATP

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

3586 Issued in ID

Practice address

211 S Woodruff Ave Ste B10
Idaho Falls, ID 83401-4866

Phone

(208) 553-7805

NPI assigned

Mar 25, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1285194134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S WOODRUFF AVE STE B10",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014866",
            "telephone_number": "208-553-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S WOODRUFF AVE STE B10",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014866",
            "telephone_number": "208-553-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "BRENT",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "ATP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "ID",
            "license": "3586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "atpbrentparker@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Secure",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4715 E 200 N",
            "city": "Rigby",
            "state": "ID",
            "country_code": "US",
            "postal_code": "834425954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mathew Greg Palmer, DDS
• Ryan Palmer, INTERN
• Andrea Lyn Pancheri, LPC
• Michael Jude Pankau, MD
• Paragon Anesthesia LLC
• Chelsee Parker
• Jason Wylie Parker, DC, NMD
• Peter Parker, DC
• Randall M. Parker, LCSW, CADC
• Robert Ean Parker, BA

• Customized Equipment (DME) in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Customized Equipment (DME) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.