Individual provider Active NPI

Brennan Loraine Hadley

  • Physical Therapist
  • Indianapolis, IN
National Provider Identifier
1407219637
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05015635A Issued in IN
Practice address
8550 Naab Rd Ste 100
Indianapolis, IN 46260-2086
Phone
(317) 338-3364
NPI assigned
Apr 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 36003046A IN
Physical Therapist 225100000X 05015635A IN Primary

Addresses

Primary practice location

8550 Naab Rd Ste 100
Indianapolis, IN 46260-2086

Mailing address

271 Lincoln HLS
Coatesville, IN 46121-8944
Phone (317) 242-9649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240906002681 IN Practitioner - Physical Therapist in Private Practice 0749720506 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05015635AINMDPhysical Therapist
36003046AINMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy on Wheels, Inc. Physical Therapist CurrentSince Aug 15, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1407219637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 LINCOLN HLS",
            "city": "COATESVILLE",
            "state": "IN",
            "postal_code": "461218944",
            "telephone_number": "317-242-9649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 NAAB RD STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602086",
            "telephone_number": "317-338-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADLEY",
        "first_name": "BRENNAN",
        "middle_name": "LORAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IN",
            "license": "36003046A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05015635A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.