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DR. KRISTENE KAE CLARK DC
NPI 1902899479
Chiropractor in Greenville, OH

Active since August 30, 2005
109 RHOADES AVE, GREENVILLE, OH 45331(937) 548-3610(937) 548-3615 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Kristene Kae Clark Dc NPPES

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

DR. KRISTENE KAE CLARK DC (NPI 1902899479) is an individual chiropractor in Greenville, Ohio, licensed in Ohio (2700) and active in the NPI registry since August 2005. She is a graduate of Logan College Of Chiropractic (1998).

NPPES Registry Identity

NPI1902899479
Entity TypeIndividualFemale
Primary Taxonomy111N00000X
Provider Legal NameDR. KRISTENE KAE CLARKCredential: DC
Location Address109 RHOADES AVEGreenville, OH 45331-2625
Mailing Address109 Rhoades AveGreenville, OH 45331-2625 · (937) 548-3610 · Fax (937) 548-3615
Phone(937) 548-3610
Fax(937) 548-3615
Sole ProprietorNo
Medical School CMSLogan College Of ChiropracticGraduated 1998
Enumeration DateAugust 30, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1902899479 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in OH · 2700
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.
109 RHOADES AVE, Greenville, OH 45331
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Other Names 1

Former Name (1)Dr. Kristene Kae Simon Dc

Other Identifiers 1

Medicaid2063225OH

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kristene Kae Clark Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID143394866
PECOS Enrollment IDI20080729000735

Medicare Billing Reassignment

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

Johnston Chiropractic Clinic Inc
Same address
Chiropractor
109 RHOADES AVENUE
Greenville, OH 45331
  • Reassigned Medicare billing, Ohio enrollment
  • 2 clinicians in this Medicare group
NPI 1922175108 (937) 548-3610

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, 1-2 spinal regions 98940
Chiropractic manipulative treatment focuses on adjusting your spine to improve your body's physical function. In this service, a chiropractor applies controlled force to 1-2 spinal regions. This helps to restore mobility and alleviate discomfort in those areas.
280 services44 patients
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.
232 services40 patients

Other Providers at the Same Location NPPES 2

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

DR. JESSICA WIGGER DC
Chiropractor
109 RHOADES AVE
GREENVILLE, OH 45331
Darke County (937) 548-3610
DR. CHARLES WILLIAM JOHNSTON DC
Chiropractor
109 RHOADES AVE
GREENVILLE, OH 45331
Darke County (937) 548-3610

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 Kristene Clark's NPI number?

The NPI number for Kristene Clark is 1902899479. It was assigned to this individual provider in the NPPES registry on August 30, 2005. The provider is also known as Dr. Kristene Kae Simon Dc.

Where is Kristene Clark located?

Kristene Clark practices at 109 Rhoades Ave, Greenville, OH 45331. The listed phone number is (937) 548-3610.

What is Kristene Clark's specialty?

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

Is Kristene Clark enrolled in Medicare?

Yes. Kristene Clark is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kristene Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kristene Clark reassigns Medicare benefits to Johnston Chiropractic Clinic Inc (Greenville, OH). 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 Kristene 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 Kristene Clark was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.