MR. JEROME DANIEL BRODERICK P.T.
NPI 1881691962
Physical Therapist in Grand Rapids, MI

Active since July 05, 2005
2911 KNAPP ST NE, SUITE C, GRAND RAPIDS, MI 49525(616) 975-9078(616) 975-9248 Get Directions Write a Review

NPPES record last updated: March 12, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Jerome Daniel Broderick P.t. NPPES

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

MR. JEROME DANIEL BRODERICK P.T. (NPI 1881691962) is an individual physical therapist in Grand Rapids, Michigan, licensed in Michigan (5501010335) and active in the NPI registry since July 2005.

NPPES Registry Identity

NPI1881691962
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameMR. JEROME DANIEL BRODERICKCredential: P.T.
Location Address2911 KNAPP ST NE, SUITE CGrand Rapids, MI 49525-4600
Mailing Address2911 Knapp St Ne, Suite CGrand Rapids, MI 49525-4600 · (616) 975-9078 · Fax (616) 975-9248
Fax(616) 975-9248
Sole ProprietorNo
Enumeration DateJuly 5, 2005
Last NPPES UpdateMarch 12, 2012
NPI 1881691962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License Licensed in MI · 5501010335
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
2911 KNAPP ST NE, Grand Rapids, MI 49525

Other Identifiers 7

OtherJB010335MI · Lisence Number
Medicare UPINN81330002MI
Medicare UPINQ03101MI
Medicare ID-Type Unspecified0N81330MI · Medicare Group Number
Other650D113250MI · Blue Cross Blue Shield Id
OtherP33049FMI · Blue Care Network Id
Medicare UPINY00967MI

Other Providers at the Same Location NPPES 4

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

Orthopaedic Surgery
2911 KNAPP ST NE, SUITE A
GRAND RAPIDS, MI 49525
Physical Therapist
2911 KNAPP ST NE, SUITE C
GRAND RAPIDS, MI 49525
Physical Therapist
2911 KNAPP ST NE, SUITE C
GRAND RAPIDS, MI 49525
Orthopaedic Surgery (Sports Medicine)
2911 KNAPP ST NE, SUITE A
GRAND RAPIDS, MI 49525

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 Jerome Broderick's NPI number?

The NPI number for Jerome Broderick is 1881691962. It was assigned to this individual provider in the NPPES registry on July 5, 2005.

Where is Jerome Broderick located?

Jerome Broderick practices at 2911 Knapp St NE Suite C, Grand Rapids, MI 49525. The listed phone number is (616) 975-9078.

What is Jerome Broderick's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

When was this NPI record last updated?

The NPPES record for Jerome Broderick was last updated on March 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.