JENNIFER A BRAKE MD
NPI 1093726713
Family Medicine - Sports Medicine in South Bend, IN

Active since August 10, 2006
111 W JEFFERSON BLVD, STE 100, SOUTH BEND, IN 46601(574) 647-1669(574) 239-6461 Get Directions Write a Review

NPPES record last updated: March 4, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jennifer A Brake Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER A BRAKE MD (NPI 1093726713) is an individual sports medicine provider in South Bend, Indiana, licensed in Indiana (01058572A) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1093726713
Entity TypeIndividualFemale
Primary Taxonomy207QS0010X
Provider Legal NameJENNIFER A BRAKECredential: MD
Location Address111 W JEFFERSON BLVD, STE 100South Bend, IN 46601-1994
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610
Fax(574) 239-6461
Sole ProprietorNo
Enumeration DateAugust 10, 2006
Last NPPES UpdateMarch 4, 2016
NPI 1093726713 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License Licensed in IN · 01058572A
Definition

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.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 01058572A (IN)
111 W JEFFERSON BLVD, South Bend, IN 46601

Other Identifiers 7

Medicare UPINI11404
Medicare PIN162520030IN
Other000000914885IN · Bcbs Bmg E. Blair Warner
Other000000914879IN · Bcbs Bmg Sports Medicine
Medicare PIN223420LL
Medicare PIN233530005IN
Medicaid200475200IN

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Specialist/Technologist (Athletic Trainer)
111 W JEFFERSON BLVD, SUITE 100
SOUTH BEND, IN 46601
Family Medicine (Sports Medicine)
111 W JEFFERSON BLVD, STE. 100
SOUTH BEND, IN 46601
Social Worker (Clinical)
111 W JEFFERSON BLVD
SOUTH BEND, IN 46601
Family Medicine (Sports Medicine)
111 W JEFFERSON BLVD, SUITE 100
SOUTH BEND, IN 46601
Acupuncturist
111 W JEFFERSON BLVD, SUITE 100
SOUTH BEND, IN 46601
Specialist/Technologist (Athletic Trainer)
111 W JEFFERSON BLVD
SOUTH BEND, IN 46601
Physical Therapist (Orthopedic)
111 W JEFFERSON BLVD
SOUTH BEND, IN 46601
Specialist
111 W JEFFERSON BLVD, SUITE 100
SOUTH BEND, IN 46601

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennifer Brake's NPI number?

The NPI number for Jennifer Brake is 1093726713. It was assigned to this individual provider in the NPPES registry on August 10, 2006.

Where is Jennifer Brake located?

Jennifer Brake practices at 111 W Jefferson Blvd Ste 100, South Bend, IN 46601. The listed phone number is (574) 647-1669.

What is Jennifer Brake's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

When was this NPI record last updated?

The NPPES record for Jennifer Brake was last updated on March 4, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.