Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1902881014 Individual Practitioner Male Practitioner

Dr. Jack J Clark , DC

Chiropractor • Fort Wayne, IN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Jack Clark, DC is a certified Chiropractor practicing in Fort Wayne, IN. With approximately 46 years of clinical experience since graduating from Western States College Of Chiropractic in 1980, Dr. Clark delivers high-quality medical care to the local community at 6015 E STATE BLVD.

Dr. Clark accepts Medicare assignment.

Frequently performed procedures and clinical services include chiropractic manipulative treatment, 3-4 spinal regions. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

6015 E State Blvd

Fort Wayne, IN 468157638

Telephone 2604861886
Associated Practice Facility / Clinic
🏢 Jack J. Clark, D.c.p.c. Facility NPI 1083820302

Medicare Profile & Education

Medical School

Western States College Of Chiropractic

Graduation Year

1980

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Fort Wayne, IN

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
46 Yrs +28.4 yrs vs City Avg
City Avg: 17.6 Yrs
State Avg: 22.0 Yrs
Regional Practice Density
85 Specialists

Practicing in Fort Wayne, IN (1470 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
1.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Clark (46 Years) 46 Yrs
Fort Wayne Specialty Average (17.6 Years) 17.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
98941 Chiropractic manipulative treatment, 3-4 spinal regions
195 33 $35.00 $34.50

Medical Specialties & State Licenses

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License IN 08000717A

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
100289660A (IN)
Commercial Insurance / Payer ID Blue Cross/blue Shield
000000086699 (IN)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 22, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location June 22, 2010

Registered at 6015 E STATE BLVD, FORT WAYNE, IN 468157638 (Tel: 2604861886)

📍
Updated Business Mailing Address June 22, 2010

Registered at 6015 E STATE BLVD, FORT WAYNE, IN 468157638 (Tel: 2604861886)

👤
Provider Name / Credentials Updated June 22, 2010

Recorded as JACK CLARK, D.C.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 22, 2010

Chiropractor (License #08000717A in IN)

🟢
Initial NPI Registration & Enumeration December 12, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1902881014
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 12, 2005
Last Update: June 22, 2010
Sole Proprietor: Yes

Mailing Address

6015 E State Blvd

Fort Wayne, IN 468157638

Phone: 2604861886

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.