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General NPI Number Information
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NPI Number | 1881134468
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Entity Type | Organization
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Legal Business Name | THOMAS A BRADY SPORTS MEDICINE CENTER, PC
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Dates
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Enumeration Date | 03/02/2017
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 19000 GRAND PARK BLVD STE K
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City | WESTFIELD
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State | IN
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Zip | 46074-6802
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Country | US
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Telephone | 317-817-1200
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Fax | 317-817-1220
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Provider Business Mailing Address
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Address Line | 10767 ILLINOIS ST STE 3000
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City | CARMEL
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State | IN
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Zip | 46032-8972
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Country | US
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Telephone | 317-817-1200
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Fax | 317-817-1220
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK RITTER
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Credential | M.D.
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Telephone | 317-817-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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