JERRY S CLARK (D.C.) – Chiropractor, NPI 1114082872

JERRY S CLARK (D.C.) is a healthcare provider. based in Provo, Utah. specializing in CHIROPRACTIC. They hold the professional credentials D.C.. They hold a License No. 166844-1202 (UT). The NPI Number for JERRY S CLARK (D.C.) is 1114082872

Main info

Male
46 Years Of Experience
Accepts Medicare Assignment
Name
JERRY S CLARK (D.C.)
NPI
1114082872
Phone
(801) 374-2774
Address
3325 N UNIVERSITY AVE STE 125
Enumeration Date
23 December 2006
Last Update Date
1 November 2016

Doctor Profile

Medical School Name
WESTERN STATES COLLEGE OF CHIROPRACTIC
Secondary Phone
8013742774
Graduation Year
1980 (46 years ago)
PAC ID
7113186586
Professional Enrollment ID
I20120306000098
Address ID
UT846046615PR3325XAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

319 CHIROPRACTIC in UT

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Provider Addresses for JERRY S CLARK (D.C.)

  • North University Avenue, North Timpview, Caryhurst, Provo, Utah County, Utah, 84604, United States

    PROVO, UT 846046615

    Phone: (801) 374-2774

    Fax: (801) 374-2775

    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: 2012-03-06

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
I20120306000098IChiropracticUTTBD

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 regions95147$0
View full utilization report →

Insurance plans in this area (ZIP 84604)

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Provider's Procedures

JERRY S CLARK (D.C.) performs procedures in CHIROPRACTIC. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CHIROPRACTICUT98940Chiropractic manipulative treatment, 1-2 spinal regions25620

Reviews

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Frequently asked questions

Can I use this page to confirm JERRY S CLARK (D.C.)'s NPI?
Yes. JERRY S CLARK (D.C.) is listed with NPI 1114082872 in the public NPI dataset.
Does CMS list JERRY S CLARK (D.C.) as active?
Yes — JERRY S CLARK (D.C.) is active in the NPI listing used on this page.
What is JERRY S CLARK (D.C.) best known for clinically?
Directory data describes JERRY S CLARK (D.C.) with Chiropractor. Clinical services aligned with this taxonomy classification.
Where should I expect JERRY S CLARK (D.C.) on a map?
Expect Provo, Utah as a primary anchor for JERRY S CLARK (D.C.) unless the record lists multiple sites.
Why does JERRY S CLARK (D.C.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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