DR. JERALD R BRODERICK D.C.
NPI 1518923945
Chiropractor in Elkhart, IN

Q: What is Jerald Broderick's NPI number?

The NPI number for Jerald Broderick is 1518923945. It was assigned to this individual provider in the NPPES registry on April 25, 2006.

Q: What is Jerald Broderick's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Q: When was this NPI record last updated?

The NPPES record for Jerald Broderick was last updated on March 16, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 25, 2006

1424 JOHNSON ST, ELKHART, IN 46514(574) 264-4151(574) 262-9891 Get Directions Write a Review

NPPES record last updated: March 16, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Jerald R Broderick D.c. NPPES

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

DR. JERALD R BRODERICK D.C. (NPI 1518923945) is an individual chiropractor in Elkhart, Indiana, licensed in Indiana (306) and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1518923945

Entity TypeIndividualMale

Primary Taxonomy111N00000X

Provider Legal NameDR. JERALD R BRODERICKCredential: D.C.

Location Address1424 JOHNSON STElkhart, IN 46514-3404

Mailing Address1424 Johnson StElkhart, IN 46514-3404 · (574) 264-4151 · Fax (574) 262-9891

Phone(574) 264-4151

Fax(574) 262-9891

Sole ProprietorYes

Enumeration DateApril 25, 2006

Last NPPES UpdateMarch 16, 2010

✔ NPI 1518923945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in IN · 306

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

1424 JOHNSON ST, Elkhart, IN 46514

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Other Identifiers 5

Medicaid100112520AIN

Medicare ID-Type Unspecified222980IN

Other306IN · Commercial/wc/aa

Medicare UPINU29275

Other000000084724IN · Blue Cross/blue Shield

Other Providers at the Same Location NPPES

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

BRODERICK CHIROPRACTIC CENTER

Chiropractor

1424 JOHNSON ST
ELKHART, IN 46514

Elkhart County (574) 264-4151

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 Jerald Broderick's NPI number?

The NPI number for Jerald Broderick is 1518923945. It was assigned to this individual provider in the NPPES registry on April 25, 2006.

Where is Jerald Broderick located?

Jerald Broderick practices at 1424 Johnson St, Elkhart, IN 46514. The listed phone number is (574) 264-4151.

What is Jerald Broderick's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

When was this NPI record last updated?

The NPPES record for Jerald Broderick was last updated on March 16, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.