JORDAN CLARK (DC) – Chiropractor, NPI 1104442417

JORDAN CLARK (DC) is a healthcare provider. based in Brighton, Michigan. specializing in CHIROPRACTIC. They hold the professional credentials DC. They hold a License No. 2301010961 (MI). The NPI Number for JORDAN CLARK (DC) is 1104442417

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
JORDAN CLARK (DC)
NPI
1104442417
Phone
(810) 494-1900
Address
10192 GRAND RIVER RD STE 107
Enumeration Date
23 June 2020
Last Update Date
23 June 2020

Doctor Profile

Medical School Name
LIFE CHIROPRACTIC COLLEGE
Secondary Phone
8104941900
Graduation Year
2019 (7 years ago)
PAC ID
6305264755
Group Practice PAC ID
2062650401
Professional Enrollment ID
I20200916002044
Address ID
MI481166531BR10192RDXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,869 CHIROPRACTIC in MI

Provider Addresses for JORDAN CLARK (DC)

  • 10192 GRAND RIVER RD STE 107

    BRIGHTON, MI 481166531

    Phone: (810) 494-1900

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-09-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200916002044IChiropracticMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
98941Chiropractic manipulative treatment, 3-4 spinal regions32921$0
View full utilization report →

Insurance plans in this area (ZIP 48116)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2062650401View full group profile
NameSpecialtyState
C H I R O P R A C T I CMI
C H I R O P R A C T I CMI

Reviews

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Frequently asked questions

What is JORDAN CLARK (DC)'s NPI number?
JORDAN CLARK (DC)'s NPI is 1104442417 — the number used across U.S. healthcare to identify this provider.
Is there an active status for JORDAN CLARK (DC)?
For scheduling context, JORDAN CLARK (DC) is shown as active in the registry.
What kind of doctor is JORDAN CLARK (DC)?
JORDAN CLARK (DC) is associated with Chiropractor in the directory — Clinical services aligned with this taxonomy classification.
Is JORDAN CLARK (DC) associated with Brighton?
Public fields place JORDAN CLARK (DC) around Brighton, Michigan. Always confirm the exact site before visiting.
Can I trust this NPI listing for JORDAN CLARK (DC)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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