Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Thaddeus Broderick

Individual provider Athletic Trainer · NPI 1639561012

Thaddeus Broderick is an Athletic Trainer in Indianapolis, Indiana. Practices as a sole proprietor. Licensed in Indiana.

Licensed in
IN
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

8102 Englewood Rd
Indianapolis, IN 46240-2749
Phone: (317) 473-7489
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X · Licence 76141 (IN)
Athletic Trainer Taxonomy 2255A2300X · Licence 76141 (IN)

Record details

NPI number1639561012
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 23, 2015
Last updated in NPPESFebruary 23, 2015

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