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JERRY S CLARK D.C.
NPI 1114082872
Chiropractor in Provo, UT

Active since December 23, 2006Accepts Medicare Assignment
3325 N UNIVERSITY AVE STE 125, PROVO, UT 84604(801) 374-2774(801) 374-2775 Get Directions Write a Review

NPPES record last updated: November 1, 2016. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Jerry S Clark D.c. NPPES

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

JERRY S CLARK D.C. (NPI 1114082872) is an individual chiropractor in Provo, Utah, licensed in Utah (166844-1202) and active in the NPI registry since December 2006. He is a graduate of Western States College Of Chiropractic (1980).

NPPES Registry Identity

NPI1114082872
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameJERRY S CLARKCredential: D.C.
Location Address3325 N UNIVERSITY AVE STE 125Provo, UT 84604-6615
Mailing Address3325 N University Ave Ste 125Provo, UT 84604-6615 · (801) 374-2774 · Fax (801) 374-2775
Phone(801) 374-2774
Fax(801) 374-2775
Sole ProprietorNo
Medical School CMSWestern States College Of ChiropracticGraduated 1980
Enumeration DateDecember 23, 2006
Last NPPES UpdateNovember 1, 2016
✔ NPI 1114082872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in UT · 166844-1202
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.
3325 N UNIVERSITY AVE STE 125, Provo, UT 84604
Open in Google Maps ↗

Other Identifiers 2

Medicare UPINT48892UT
Medicare ID-Type Unspecified005554301UT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jerry S Clark D.c. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113186586
PECOS Enrollment IDI20120306000098

Medicare Billing Reassignment

Medicare enrollment records show Jerry Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Alpine Spinal Rehabilitation Ctr
Same address
Chiropractor
3325 N UNIVERSITY AVE STE 125
Provo, UT 84604
  • Reassigned Medicare billing, Utah enrollment
NPI 1578731949 (801) 374-2774

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chiropractic manipulative treatment, 3-4 spinal regions 98941
Chiropractic manipulative treatment for 3-4 spinal regions involves a trained professional applying controlled force to specific areas of your spine. This can help alleviate pain, improve physical function, and support your body's natural healing process.
806 services55 patients
Chiropractic manipulative treatment, 5 spinal regions 98942
Chiropractic manipulative treatment focuses on adjusting your spine to improve your body's alignment. In a 5 spinal region treatment, the chiropractor applies controlled force to specific areas in your neck, mid-back, lower back, and both sides of your pelvis.
173 services18 patients

Other Providers at the Same Location NPPES 4

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

ALPINE SPINAL REHABILITATION CTR
Chiropractor
3325 N UNIVERSITY AVE STE 125
PROVO, UT 84604
Utah County (801) 374-2774
ALPINE SPINAL HEALTH
Chiropractor
3325 N UNIVERSITY AVE STE 125
PROVO, UT 84604
Utah County (801) 374-2774
COMPLETE VITALITY
Chiropractor
3325 N UNIVERSITY AVE STE 125
PROVO, UT 84604
Utah County (801) 374-2774
CHARLES VANCHIERE DC
Chiropractor
3325 N UNIVERSITY AVE STE 125
PROVO, UT 84604
Utah County (801) 374-2774

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 Jerry Clark's NPI number?

The NPI number for Jerry Clark is 1114082872. It was assigned to this individual provider in the NPPES registry on December 23, 2006.

Where is Jerry Clark located?

Jerry Clark practices at 3325 N University Ave Ste 125, Provo, UT 84604. The listed phone number is (801) 374-2774.

What is Jerry Clark's specialty?

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

Is Jerry Clark enrolled in Medicare?

Yes. Jerry Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jerry Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jerry Clark reassigns Medicare benefits to Alpine Spinal Rehabilitation Ctr (Provo, UT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jerry Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jerry Clark accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Utah list Jerry Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jerry Clark was last updated on November 1, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.