Individual provider Active NPI

Brady Michael Peters

  • Physician Assistant
  • Spartanburg, SC
National Provider Identifier
1366304354
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6127 Issued in SC
Practice address
1330 Boiling Springs Rd Ste 1540
Spartanburg, SC 29303-4224
Phone
(864) 560-2663
Fax
(864) 560-5301
NPI assigned
Nov 26, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6127 SC Primary

Addresses

Primary practice location

1330 Boiling Springs Rd Ste 1540
Spartanburg, SC 29303-4224

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bpeters287978@direct-srhs.et0939.epichosted.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251223000017 SC Practitioner - Physician Assistant 3971098492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

100 E Wood St
Spartanburg, SC 29303-3004
Phone (864) 560-7070

101 E Wood St
Spartanburg, SC 29303-3040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6127SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center CurrentSince Dec 1, 2025 Accepting new patients
Spartanburg Medical Center CurrentSince Dec 1, 2025 Accepting new patients

Locations

1330 Boiling Springs Rd
Ste 1540
Spartanburg, SC 29303
Phone (864) 560-2663

100 E Wood St
Spartanburg, SC 29303
Phone (864) 560-7070

Interoperability endpoints

  • Direct secure messaging: bpeters287978@direct-srhs.et0939.epichosted.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1764115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1366304354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BOILING SPRINGS RD STE 1540",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034224",
            "telephone_number": "864-560-2663",
            "fax_number": "864-560-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "BRADY",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-26",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "6127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bpeters287978@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bpeters287978@direct-srhs.et0939.epichosted.com",
            "address_1": "1330 Boiling Springs Rd Ste 1540",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293034224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.