DR. KERI RAND CLARK PH.D.
NPI 1477882793
Psychologist in Tacoma, WA

NPI Status: Active since December 15, 2009

Contact Information

MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA, WA
ZIP 98431
Phone: (253) 967-8283

Get Directions Reviews

  • Individual
  • Male
  • Psychologist
  • Opted-Out Medicare

About KERI CLARK

This page provides the complete NPI Profile along with additional information for Keri Clark, a provider established in Tacoma, Washington with a medical specialization in Psychologist. The healthcare provider is registered in the NPI registry with number 1477882793 assigned on December 2009. The practitioner's primary taxonomy code is 103T00000X with license number PY00002548 (WA). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1477882793
Provider Name
DR. KERI RAND CLARK PH.D.
Gender
Male
Entity Type
Individual
Location Address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE TACOMA, WA 98431
Location Phone
(253) 967-8283
Mailing Address
MADIGAN ARMY MEDICAL CENTER MCHJ CP 9040 A FITZIMMONS DRIVE TACOMA, WA 98431
Mailing Phone
(253) 968-5140
Is Sole Proprietor?
No
Enumeration Date
12-15-2009
Last Update Date
07-27-2020
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A psychologist like Keri Clark studies cognitive, emotional, social processes and behavior by observing, interpreting, and recording how people relate to one another and to their environments. Psychologists gather information and evaluate behavior through controlled laboratory experiments, psychoanalysis, psychotherapy or through personality, performance, aptitude, or intelligence tests, and use this information when testing theories in their research or when treating patients.

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Keri Clark opted out of Medicare effective on 06-19-2024 until 06-19-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychologist

Taxonomy Code
103T00000X
Type
Behavioral Health & Social Service Providers
License No.
PY00002548
License State
WA
Taxonomy Description
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Medicare Participation & PECOS Enrollment Status

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Opted-Out of Medicare? Yes

  • Opt-Out Effective Date: 06-19-2024

  • Opt-Out End Date: 06-19-2026

  • Eligible to Order and Refer? No

Reviews for DR. KERI RAND CLARK PH.D.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1477882793
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
241471684718
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 1 + 4 + 7 + 1 + 6 + 8 + 4 + 7 + 1 + 8 + 24 = 77
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 77 = 33

The NPI number 1477882793 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1255793030 SUSAN EILEEN CHAMBERS RN
Individual
Registered NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 968-1643
1720440472 CYNTHIA BAKER RN
Individual
Registered NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 968-3681
1629430129MS. NICOLE CAMEJO RN
Individual
Registered NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 966-6520
1922460302 JODEE DEARDORFF-ROBERSON RN-BSN
Individual
Registered NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 477-4857
1851754725 ALICE TORRES RN
Individual
Registered NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 968-2555
1619330479 ENRIQUE ECHIVERRI R.N.
Individual
Registered NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 968-0758
1255795654 SOHEE I OH PHARM.D.
Individual
PharmacistMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 968-2510
1770947905 JOSHUA CHAMBERLAIN
Individual
Emergency Medical Technician, BasicMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA, WA 98431
(210) 763-0646
1134575533 LAUREN HUNTOON
Individual
Registered Nurse (Ambulatory Care)MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 968-0770
1710333844MRS. CINA MARGARET MCBRIDE LPN
Individual
Licensed Practical NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 968-2462
1215260740DR. MONICA J KWAK PHARM.D
Individual
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE DEPARTMENT OF PHARMACY
TACOMA, WA 98431
(253) 968-2015
1346690211 SARA DUNN R.N.
Individual
Registered NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 968-0758
1699126565MS. LIZETTE ZERMENO RN
Individual
Registered NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 968-3030
1710338264 KAREN ANN TRAHANES-SMITH
Individual
Licensed Practical NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE MCHJ-CLQ-C,
TACOMA, WA 98431
(253) 968-1420
1386197432 JENNIFER BROUGHTON
Individual
Registered NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 968-0758
1134674229 ELIZABETH MARIE SERRANO LPN
Individual
Licensed Practical NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 376-8975
1760938856MR. JOHN PATRICK RUPPE RN
Individual
Registered NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 968-2235
1306393483 BARBARA ANN COOK RN
Individual
Registered NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 968-0667
1942757901 HEE GOO KWAK
Individual
Registered NurseMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 968-1110
1952859381 PHOENIX RISING HORN EMT PARAMEDIC
Individual
Emergency Medical Technician, ParamedicMADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C
TACOMA, WA 98431
(253) 968-1100

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1477882793, enumerated in the NPI registry as an "individual" on December 15, 2009

The provider is located at Madigan Army Medical Center 9040 Jackson Ave Tacoma, Wa 98431 and the phone number is (253) 967-8283

The provider's speciality is Psychologist with taxonomy code 103T00000X

No, the provider signed an affidavit on June 19, 2024 to opt-out of the Medicare program. The provider is excluded from the Medicare program until June 19, 2026.

This NPI record was last updated on December 15, 2009. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.