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
- 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
- Code Navigator
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. | |||||||||
1 | 4 | 7 | 7 | 8 | 8 | 2 | 7 | 9 | 3 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 4 | 14 | 7 | 16 | 8 | 4 | 7 | 18 | |
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 = 3 | 3 |
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 Nurse | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C TACOMA, WA 98431 (253) 968-1643 |
1720440472 | CYNTHIA BAKER RN Individual | Registered Nurse | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C TACOMA, WA 98431 (253) 968-3681 |
1629430129 | MS. NICOLE CAMEJO RN Individual | Registered Nurse | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C TACOMA, WA 98431 (253) 966-6520 |
1922460302 | JODEE DEARDORFF-ROBERSON RN-BSN Individual | Registered Nurse | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C TACOMA, WA 98431 (253) 477-4857 |
1851754725 | ALICE TORRES RN Individual | Registered Nurse | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C TACOMA, WA 98431 (253) 968-2555 |
1619330479 | ENRIQUE ECHIVERRI R.N. Individual | Registered Nurse | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C TACOMA, WA 98431 (253) 968-0758 |
1255795654 | SOHEE I OH PHARM.D. Individual | Pharmacist | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C TACOMA, WA 98431 (253) 968-2510 |
1770947905 | JOSHUA CHAMBERLAIN Individual | Emergency Medical Technician, Basic | MADIGAN 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 |
1710333844 | MRS. CINA MARGARET MCBRIDE LPN Individual | Licensed Practical Nurse | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C TACOMA, WA 98431 (253) 968-2462 |
1215260740 | DR. 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 Nurse | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C TACOMA, WA 98431 (253) 968-0758 |
1699126565 | MS. LIZETTE ZERMENO RN Individual | Registered Nurse | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C TACOMA, WA 98431 (253) 968-3030 |
1710338264 | KAREN ANN TRAHANES-SMITH Individual | Licensed Practical Nurse | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE MCHJ-CLQ-C, TACOMA, WA 98431 (253) 968-1420 |
1386197432 | JENNIFER BROUGHTON Individual | Registered Nurse | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C TACOMA, WA 98431 (253) 968-0758 |
1134674229 | ELIZABETH MARIE SERRANO LPN Individual | Licensed Practical Nurse | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C TACOMA, WA 98431 (253) 376-8975 |
1760938856 | MR. JOHN PATRICK RUPPE RN Individual | Registered Nurse | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C TACOMA, WA 98431 (253) 968-2235 |
1306393483 | BARBARA ANN COOK RN Individual | Registered Nurse | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE ATTN: MCHJ-CLQ-C TACOMA, WA 98431 (253) 968-0667 |
1942757901 | HEE GOO KWAK Individual | Registered Nurse | MADIGAN 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, Paramedic | MADIGAN 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.