Individual provider Active NPI

Brent Matthew Parker, DPT

  • Physical Therapist
  • Lake Wylie, SC
National Provider Identifier
1740836220
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12293 Issued in SC
Practice address
439 Channel Rd Ste 102
Lake Wylie, SC 29710-6101
Phone
(803) 746-7800
NPI assigned
Aug 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 27598 MD
Physical Therapist 225100000X 12293 SC Primary

Addresses

Primary practice location

439 Channel Rd Ste 102
Lake Wylie, SC 29710-6101

Mailing address

PO Box 412066
Boston, MA 02241-6101
Phone (914) 294-4050

Other practice location 1

910 Frederick Rd
Catonsville, MD 21228-4516
Phone (410) 644-1880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, SC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20191011001721 MD Practitioner - Physical Therapist in Private Practice 0244561801 Reassigns benefits to 2 organizations
I20230507000040 DC Practitioner - Physical Therapist in Private Practice 0244561801 Reassigns benefits to 1 organization
I20240422000230 SC Practitioner - Physical Therapist in Private Practice 0244561801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Maryland School of Medicine, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Rehab 2 Perform LLCGroup PAC ID 6002199064, 92 clinicians

Practice addresses (Care Compare)

983 Waugh Chapel Way
Suite Ab
Gambrills, MD 21054-1261
Phone (301) 798-4838

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
57.41
Promoting interoperability
100
Improvement activities
40
Cost
80.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Focus, Inc. CurrentSince Jan 6, 2025 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Aug 26, 2019 Accepting new patients
Beaufort Orthopaedic Sports and Spine Center LLC CurrentSince Apr 15, 2024 Accepting new patients
Maryland Luna Care Physical Therapy LLC Physical Therapist CurrentSince Apr 25, 2023 Accepting new patients
Centers for Advanced Orthopaedics, LLC Current Accepting new patients
Rehab 2 Perform LLC Physical Therapist CurrentSince Jul 7, 2025 Accepting new patients
Rehab 2 Perform LLC Physical Therapist CurrentSince Jul 7, 2025 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Aug 26, 2019 Accepting new patients
Beaufort Orthopaedic Sports and Spine Center LLC CurrentSince Apr 15, 2024 Accepting new patients
Ivyrehab Focus, Inc. Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Carolina Rehabilitation Inc Physical Therapist Current Accepting new patients

Locations

1750 Forest Dr
Ste 145
Annapolis, MD 21401
Phone (301) 381-0738

910 Frederick Rd
Catonsville, MD 21228

5425 Wisconsin Ave
Ste 600
Chevy Chase, MD 20815
Phone (301) 818-1575

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

1341 Hughes Ford Rd
Ste 104
Frederick, MD 21701
Phone (301) 450-8038

983 Waugh Chapel Way
Ste Ab
Gambrills, MD 21054
Phone (301) 603-3008

983 Waugh Chapel Way
Ste A
Gambrills, MD 21054

20501 Seneca Meadows Pkwy
Ste 100
Germantown, MD 20876
Phone (240) 608-0986

1076 Ribaut Rd
Ste 102
Beaufort, SC 29902
Phone (843) 521-1970

1076 Ribaut Rd
Ste 101
Beaufort, SC 29902
Phone (843) 525-0045

439 Channel Rd
Ste 102
Lake Wylie, SC 29710
Phone (619) 977-0480

Organizations & group practices 11

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": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1740836220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412066",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416101",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 CHANNEL RD STE 102",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297106101",
            "telephone_number": "803-746-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 Frederick Rd",
            "address_purpose": "LOCATION",
            "city": "Catonsville",
            "state": "MD",
            "postal_code": "212284516",
            "country_code": "US",
            "telephone_number": "410-644-1880",
            "fax_number": "410-646-3623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "BRENT",
        "middle_name": "MATTHEW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-12",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27598",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wylie, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.