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Jack Broaddus, ATC

Athletic Trainer in Ann Arbor, MI · enumerated 2023.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1134805096

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Registry record

Entity type Individual (Type 1)
Name Jack Broaddus
Credential ATC
Sex Male
Practice address 1200 S State St, Ann Arbor, MI, 48109
Phone (734) 647-2583
Enumeration date Jun 26, 2023
Last updated in NPPES Jun 26, 2023

Taxonomy & licenses

2255A2300X Athletic Trainer Respiratory, Developmental, Rehabilitative and Restorative Service Providers · License 2601002903 (MI) Primary

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Jack Broaddus?
The National Provider Identifier (NPI) for Jack Broaddus is 1134805096, a Type 1 (individual) record in the CMS NPPES registry.
Where does Jack Broaddus practice?
The practice location on file with NPPES is in Ann Arbor, MI. Providers can have multiple locations; NPPES lists the primary practice address.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-06-26.