David Jacks, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

C5066 Issued in AR

Practice address

4303 S Mulberry St
Pine Bluff, AR 71603-7017

Phone

(870) 535-4221

Fax

(870) 535-4228

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

89.18 of 100Reported as group

Quality

90.37

Promoting interoperability

100

Improvement activities

40

Cost

73.56

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.jacks@carti.oncoemrdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central Arkansas Radiation Therapy Institute Inc

  • Hematology & Oncology Physician
  • Little Rock, AR
  • NPI 1508147810
  Medicare reassignment NPD
• Central Arkansas Radiation Therapy Institute Inc

  • Clinical Social Worker
  • Little Rock, AR
  • NPI 1205425352
  NPD
• Central Arkansas Radiation Therapy Institute Inc

  • Ambulatory Surgical Clinic/Center
  • Little Rock, AR
  • NPI 1902472715
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1093735110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4303 S MULBERRY ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037017",
            "telephone_number": "870-535-4221",
            "fax_number": "870-535-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4303 S MULBERRY ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037017",
            "telephone_number": "870-535-4221",
            "fax_number": "870-535-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKS",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AR",
            "license": "C5066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10493001",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "david.jacks@carti.OncoEMRDirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4303 S Mulberry St",
            "city": "Pine Bluff",
            "state": "AR",
            "country_code": "US",
            "postal_code": "716037017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Staci D Irby
• It'S All Good Counseling & Clinical Services, LLC
• Roslyn R Iverson
• J. W Nuckolls MD
• Jacks Dermatology P.a.
• Dennis W Jacks, M.D.
• Jennifer Lynn Jacks, M.D.
• Angela Jackson, COTA
• Corey Lamont Jackson Sr., D.C.
• Debra A Jackson

• Urology Physician in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Urology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.