Brent Deatherage, PA-C
NPI 1336373257 · Medical Physician Assistant · Charlotte, NC
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Brent Deatherage, PA-C is a Medical Physician Assistant provider in Charlotte, NC (NPI 1336373257).
Provider details
- NPI number
- 1336373257
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA9104956 (FL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2009-05-06
- Last updated
- 2012-08-10
Frequently asked questions
- What is Brent Deatherage's NPI number?
- Brent Deatherage's National Provider Identifier (NPI) is 1336373257, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Brent Deatherage's specialty?
- Brent Deatherage is listed in the NPPES registry with a primary specialty of Medical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Brent Deatherage located?
- Brent Deatherage's practice location on file with NPPES is 1900 Randolph Rd, Charlotte, NC 28207-1122.
- What is Brent Deatherage's phone number?
- The practice phone number listed in the NPPES registry for Brent Deatherage is (704) 377-2424.
- Does Brent Deatherage accept Medicare?
- Brent Deatherage is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Brent Deatherage's NPI active?
- Yes — Brent Deatherage's NPI (1336373257) is active in the NPPES registry as of the last update on 2012-08-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.