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JENNIFER A BRAKE MD NPI 1093726713


NPI Information

NPI: 1093726713
Provider Name: JENNIFER A BRAKE, MD
Classification: Family Medicine - 207QS0010X
Entity Type: Individual

Specialization: Sports Medicine

Address:
111 W JEFFERSON BLVD
STE 100
SOUTH BEND, IN
ZIP 46601
Phone: (574) 647-1669
Get Directions

Jennifer A Brake, MD is a sports medicine family medicine in South Bend, IN. The provider is a family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. Jennifer A Brake, MD NPI is 1093726713. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

111 W JEFFERSON BLVD
STE 100
SOUTH BEND, IN
ZIP 46601-994
Phone: (574) 647-1669
Fax: (574) 239-6461

The enumeration date for this NPI number is 8/10/2006 and was last updated on 3/4/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine01058572AINDIANANo
2207QS0010XFamily MedicineSports Medicine01058572AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1I11404MEDICARE UPIN
2162520030MEDICARE PININDIANA
3000000914885OTHERINDIANABCBS BMG E. BLAIR WARNER
4000000914879OTHERINDIANABCBS BMG SPORTS MEDICINE
5223420LLMEDICARE PIN
6233530005MEDICARE PININDIANA
7200475200MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.