Garry Lee Brady, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

02004413A Issued in IN

Practice address

716 S College Ave
Rensselaer, IN 47978-3083

Phone

(219) 866-0485

Fax

(219) 866-0837

NPI assigned

Jun 27, 2008

Last updated

Jul 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12167/brand/1/csg/1/fhir/r4

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

• Christian Clinic PC

  • Family Medicine Physician
  • Rensselaer, IN
  • NPI 1558763987
  Medicare reassignment NPD
• Jasper County After Hours Urgent Care Inc

  • Urgent Care Clinic/Center
  • Rensselaer, IN
  • NPI 1235689480
  NPD
• Vein Associates of Northwest Indiana LLC

  • Clinic/Center
  • Merrillville, IN
  • NPI 1801217856
  NPD (past)

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1457513764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 S COLLEGE AVE",
            "city": "RENSSELAER",
            "state": "IN",
            "postal_code": "479783083",
            "telephone_number": "291-866-0485",
            "fax_number": "219-866-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 S COLLEGE AVE",
            "city": "RENSSELAER",
            "state": "IN",
            "postal_code": "479783083",
            "telephone_number": "219-866-0485",
            "fax_number": "219-866-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "GARRY",
        "middle_name": "LEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "02004413A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Louise Benedict, MSN,FNP
• Tracy Marie Rochester Biggs
• Tiffany Bluemke
• Tonya Kay Bonnell, FNP-C
• Kimberly Bousema, PA
• Emily Bridgeman, ED.S
• John Bryant, MS LMFT LCAC
• Christian Clinic PC
• Christopher Adam Conn, MD
• Jeffrey D'Angelo, RPH

• General Practice Physician in Rensselaer, IN
• Providers in Rensselaer, IN by specialty
• General Practice Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.