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JACK J. CLARK, D.C.P.C.
NPI 1083820302
Chiropractor in Fort Wayne, IN

Active since May 15, 2007
6015 E STATE BLVD, FORT WAYNE, IN 46815(260) 486-1886 Get Directions Write a Review

NPPES record last updated: June 27, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jack J. Clark, D.c.p.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK J. CLARK, D.C.P.C. (NPI 1083820302) is a healthcare organization registered as a chiropractor in Fort Wayne, Indiana and active in the NPI registry since May 2007. The organization lists Valerie Badiac, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1083820302
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameJACK J. CLARK, D.C.P.C.
Location Address6015 E STATE BLVDFort Wayne, IN 46815-7638
Mailing Address6015 E State BlvdFort Wayne, IN 46815-7638 · (260) 486-1886 · Fax (260) 485-3958
Phone(260) 486-1886
Organization SubpartNo
Authorized OfficialValerie BadiacOffice Manager · (260) 486-1886
Enumeration DateMay 15, 2007
Last NPPES UpdateJune 27, 2008
✔ NPI 1083820302 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in IN · 08000717A
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Also ListedChiropractor · RehabilitationTaxonomy 111NR0400X · License 08002245A (IN)
6015 E STATE BLVD, Fort Wayne, IN 46815
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Other Identifiers 2

Medicare PIN197110IN
Medicaid100289660AIN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JACK J CLARK D.C.
Chiropractor
6015 E STATE BLVD
FORT WAYNE, IN 46815
Allen County (260) 486-1886

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack J. Clark, D.C.P.C.'s NPI number?

The NPI number for Jack J. Clark, D.C.P.C. is 1083820302. It was assigned to this organization in the NPPES registry on May 15, 2007.

Where is Jack J. Clark, D.C.P.C. located?

Jack J. Clark, D.C.P.C. is located at 6015 E State Blvd, Fort Wayne, IN 46815. The listed phone number is (260) 486-1886.

What is Jack J. Clark, D.C.P.C.'s specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

When was this NPI record last updated?

The NPPES record for Jack J. Clark, D.C.P.C. was last updated on June 27, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.