Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jacob Alexander Braddock, DO

Individual provider Family Medicine Physician · NPI 1801470984

Dr. Jacob Alexander Braddock, DO is a Family Practice in South Bend, Indiana. Graduated from Lake Erie College of Osteopathic Medicine, Erie in 2021, 5 years ago. Practices with Commonspirit Kansas Inc, a 68-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Indiana and Kansas.

Years since qualifying
5
Trained at
Lake Erie College of Osteopathic Medicine, Erie
Licensed in
IN, KS
In the registry since
2021
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

714 N Michigan St
South Bend, IN 46601-1035
Phone: (574) 647-7477
Fax: (574) 647-3655
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1100 Mercer Ave, Decatur, IN 46733-2303 — (260) 724-2145
  • 112 W Ross Blvd Ste D, Dodge City, KS 67801-7220 — (620) 371-7044

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 02007857A (IN)
Family Medicine Physician Taxonomy 207Q00000X · Licence 05-51049 (KS)

Record details

NPI number1801470984
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 6, 2021
Last updated in NPPESJune 30, 2026
Certification dateJune 30, 2026
Mailing address3245 Health Dr Ste 100, Granger, IN 46530-1380

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated 2021 (5 years in practice)
Group practice Commonspirit Kansas Inc — 68 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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