Jack J. Clark, D.C.
NPI 1902881014ActiveIndividual· Chiropractor· Fort Wayne, IN
Chiropractor (D.C.) in Fort Wayne, Indiana, trained at Western States College of Chiropractic (class of 1980). Medicare paid $4,791 for services to 33 patients in 2024.
Overview
| NPI | 1902881014 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | D.C. |
| Sole proprietor | Yes |
| NPI issued | Dec 12, 2005 |
| Last updated in NPPES | Jun 22, 2010 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Chiropractor Primary | 111N00000X | 08000717A | IN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Chiropractic (IN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 33 |
|---|---|
| Services billed | 195 across 1 procedure code |
| Paid by Medicare | $4,791 |
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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