MR. DAVID B JACK MD
NPI 1255434296
Family Medicine - Obesity Medicine in Draper, UT
Active since September 06, 2006
74 E KIMBALLS LN STE 260, DRAPER, UT 84020(801) 545-8480(801) 253-1602 Get Directions Write a Review
About Mr. David B Jack Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. DAVID B JACK MD (NPI 1255434296) is an individual obesity medicine provider in Draper, Utah, licensed in Utah (168941-1205) and active in the NPI registry since September 2006.
NPPES Registry Identity
NPI1255434296
Entity TypeIndividualMale
Primary Taxonomy207QB0002X
Provider Legal NameMR. DAVID B JACKCredential: MD
Location Address74 E KIMBALLS LN STE 260Draper, UT 84020-5009
Mailing AddressPo Box 198560Atlanta, GA 30384-1721
Phone(801) 545-8480
Fax(801) 253-1602
Sole ProprietorNo
Enumeration DateSeptember 6, 2006
Last NPPES UpdateFebruary 1, 20222 updates tracked since enumeration
NPPES CertifiedDecember 23, 2020
✔ NPI 1255434296 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyFamily Medicine · Obesity MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QB0002X
License✔ Licensed in UT · 168941-1205
Definition
A family medicine physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity.
74 E KIMBALLS LN STE 260, Draper, UT 84020
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Reported Quality Measures
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
74%232 patients4/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
60%498 patients3/55-star benchmark: 85%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
90%108 patients4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
96%2,693 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
82%1,517 patients2/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
99%451 patients5/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
97%151 patients5/55-star benchmark: 88%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
79%553 patients4/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
65%451 patients3/55-star benchmark: 90%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
28%814 patients2/55-star benchmark: 96%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%553 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
63%553 patients3/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
23%553 patients
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.
100%23 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Internal Medicine (Cardiovascular Disease)
74 E KIMBALLS LN STE 260
DRAPER, UT 84020
DRAPER, UT 84020
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 David Jack's NPI number?
The NPI number for David Jack is 1255434296. It was assigned to this individual provider in the NPPES registry on September 6, 2006.
Where is David Jack located?
David Jack practices at 74 E Kimballs Ln Ste 260, Draper, UT 84020. The listed phone number is (801) 545-8480.
What is David Jack's specialty?
The primary specialty registered for this NPI is Family Medicine, specializing in Obesity Medicine, with taxonomy code 207QB0002X.
When was this NPI record last updated?
The NPPES record for David Jack was last updated on February 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Mr. David B Jack, MD · NPI 1255434296
Obesity Medicine physician in Draper, Utah. Individual provider, active in the CMS NPPES registry since September 6, 2006.
## Identity
- **NPI:** 1255434296 (Entity type: Individual)
- **Enumerated:** September 6, 2006
- **Primary specialty:** Family Medicine - Obesity Medicine · taxonomy 207QB0002X
- **State license:** 168941-1205 (Utah)
- **Sole proprietor:** No
## Practice location
- **Address:** 74 E KIMBALLS LN STE 260, Draper, UT 84020-5009
- **Phone:** (801) 545-8480 · **Fax:** (801) 253-1602
## Record status
- **NPPES last updated:** February 1, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1255434296) · Data from the CMS NPPES public registry.