Healthcare Provider Details

I. General information

NPI: 1407251382
Provider Name (Legal Business Name): THOMAS A BRADY SPORTS MEDICINE CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2014
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 S MAIN ST, STE 100
TIPTON IN
46072-9753
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: 317-817-1200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK RITTER
Title or Position: PRESIDENT
Credential: MD
Phone: 317-817-1200