DR. JENNIFER M. CLARK D.C.
NPI 1144389024
Chiropractor in Peoria, IL
About Dr. Jennifer M. Clark D.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JENNIFER M. CLARK D.C. (NPI 1144389024) is an individual chiropractor in Peoria, Illinois and active in the NPI registry since December 2006. She is a graduate of Other (2005).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Jennifer M. Clark D.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jennifer Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Peoria, IL 61614
- Reassigned Medicare billing, Illinois enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PEORIA, IL 61614
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 Jennifer Clark's NPI number?
The NPI number for Jennifer Clark is 1144389024. It was assigned to this individual provider in the NPPES registry on December 7, 2006.
Where is Jennifer Clark located?
Jennifer Clark practices at 4900 N Glen Park Place Rd Suite B, Peoria, IL 61614. The listed phone number is (309) 645-9665.
What is Jennifer Clark's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Jennifer Clark enrolled in Medicare?
Yes. Jennifer Clark is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jennifer Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Clark reassigns Medicare benefits to Clark Chiropractic Center, LLC (Peoria, IL). 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 Jennifer Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jennifer Clark was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Dr. Jennifer M. Clark, D.C. · NPI 1144389024
Chiropractor provider in Peoria, Illinois. Individual provider, active in the CMS NPPES registry since December 7, 2006.
## Identity
- **NPI:** 1144389024 (Entity type: Individual)
- **Enumerated:** December 7, 2006
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Sole proprietor:** No
## Practice location
- **Address:** 4900 N GLEN PARK PLACE RD, SUITE B, Peoria, IL 61614-4679
- **Phone:** (309) 645-9665
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Clark Chiropractic Center, LLC (NPI 1215090337, Peoria, IL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2005
## Record status
- **NPPES last updated:** July 8, 2007
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Source: [NPI Profile](https://npiprofile.com/npi/1144389024) · Data from the CMS NPPES public registry.