Jerry S. Clark, D.C.
NPI 1114082872ActiveIndividual· Chiropractor· Provo, UT
Chiropractor (D.C.) in Provo, Utah, trained at Western States College of Chiropractic (class of 1980). Medicare paid $28,920 for services to 56 patients in 2024.
Overview
| NPI | 1114082872 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | D.C. |
| Sole proprietor | No |
| NPI issued | Dec 23, 2006 |
| Last updated in NPPES | Nov 1, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Chiropractor Primary | 111N00000X | 166844-1202 | UT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Chiropractic (UT) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 56 |
|---|---|
| Services billed | 979 across 2 procedure codes |
| Paid by Medicare | $28,920 |
Education and affiliations
| Medical school | Western States College of Chiropractic |
|---|---|
| Graduation year | 1980 |
| Medicare specialty | Chiropractic |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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