Healthcare Provider Details

I. General information

NPI: 1487473070
Provider Name (Legal Business Name): THOMAS A BRADY SPORTS MEDICINE CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10767 ILLINOIS ST STE 1200
CARMEL IN
46032-8972
US

IV. Provider business mailing address

10767 ILLINOIS ST STE 3000
CARMEL IN
46032-8972
US

V. Phone/Fax

Practice location:
  • Phone: 317-817-1200
  • Fax: 317-817-1220
Mailing address:
  • Phone: 317-817-1200
  • Fax: 317-817-1220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN PATRICK SMEREK
Title or Position: PRESIDENT
Credential: MD
Phone: 317-817-1200