Individual provider Active NPI

Tara C. Brady, PHYSICAL THERAPIST

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1427028869
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11086 Issued in SC
Practice address
535 W Butler Rd Ste a
Greenville, SC 29607-4833
Phone
(864) 277-2747
NPI assigned
Jan 26, 2006
Last updated
Apr 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11086 SC Primary

Addresses

Primary practice location

535 W Butler Rd Ste a
Greenville, SC 29607-4833

Mailing address

200 Timberleaf Dr
Duncan, SC 29334-9297
Phone (845) 304-3905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220622002982 SC Practitioner - Physical Therapist in Private Practice 2264465566 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Medical Group, PLLC CurrentSince Apr 11, 2022 Accepting new patients
Palmetto Medical Group, PLLC CurrentSince Apr 11, 2022 Accepting new patients
Matrix Rehabilitation-South Carolina, Inc. Physical Therapist PastSince Apr 13, 2025 Accepting new patients
Matrix Rehabilitation South Carolina, Inc. PastSince Apr 13, 2025 Accepting new patients

Locations

1040 Edgewater Corporate Pkwy
Ste 101
Indian Land, SC 29707
Phone (803) 548-7007

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1427028869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TIMBERLEAF DR",
            "city": "DUNCAN",
            "state": "SC",
            "postal_code": "293349297",
            "telephone_number": "845-304-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 W BUTLER RD STE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074833",
            "telephone_number": "864-277-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "TARA",
        "middle_name": "C.",
        "name_prefix": "Mrs.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "11086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.