Individual provider Active NPI

Brindis Nicole Lundberg, DPT, PT

  • Physical Therapist
  • Rock Hill, SC
National Provider Identifier
1699590356
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13306 Issued in SC
Practice address
1317 Ebenezer Rd
Rock Hill, SC 29732-2336
Phone
(803) 207-8177
Fax
(803) 207-8130
NPI assigned
Nov 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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 13306 SC Primary

Addresses

Primary practice location

1317 Ebenezer Rd
Rock Hill, SC 29732-2336

Mailing address

1317 Ebenezer Rd
Rock Hill, SC 29732-2336
Phone (803) 207-8177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241202001254 TX Practitioner - Physical Therapist in Private Practice 0840725701
I20260507000971 SC Practitioner - Physical Therapist in Private Practice 0840725701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1317 Ebenezer Rd
Rock Hill, SC 29732-2336

1531 Crestdale Rd
Rock Hill, SC 29732-1474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13306SCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Rehabilitation and Sports Medicine Limited Partnership Physical Therapist CurrentSince Sep 26, 2024 Accepting new patients
Mission Rehabilitation and Sports Medicine Limited Partnership Physical Therapist CurrentSince Sep 26, 2024 Accepting new patients
Revo Rehab, Inc Physical Therapist CurrentSince Mar 23, 2026 Accepting new patients

Locations

727 Dilworth Ln
Ste 202
Rock Hill, SC 29732
Phone (803) 327-8655

1317 Ebenezer Rd
Rock Hill, SC 29732
Phone (803) 207-8177

12413 Judson Rd
Ste 260
Live Oak, TX 78233
Phone (210) 656-7953

7390 Barlite Blvd
Ste 310
San Antonio, TX 78224
Phone (210) 534-7953

3875 E Southcross Blvd
Ste B
San Antonio, TX 78222
Phone (210) 337-7953

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.

NPI Registry JSON

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1699590356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322336",
            "telephone_number": "803-207-8177",
            "fax_number": "803-207-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322336",
            "telephone_number": "803-207-8177",
            "fax_number": "803-207-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDBERG",
        "first_name": "BRINDIS",
        "middle_name": "NICOLE",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-18",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "13306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.