Individual provider Active NPI

David Bradley Jenks Jr., PH.D., LMFT

  • Marriage & Family Therapist
  • Layton, UT
National Provider Identifier
1255876777
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
2121 N 1700 W
Layton, UT 84041-8803
Phone
(801) 773-4840
NPI assigned
Dec 20, 2016
Last updated
Apr 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

2121 N 1700 W
Layton, UT 84041-8803

Mailing address

2185 N 500 E
North Logan, UT 84341-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240104000808 UT Practitioner - Marriage and Family Therapist 7012368079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians

Practice addresses (Care Compare)

1660 W Antelope Dr
Layton, UT 84041-1156
Phone (801) 525-8726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Memorial Clinic Current Accepting new patients
Tanner Memorial Clinic CurrentSince Jan 1, 2024 Accepting new patients
Tanner Memorial Clinic CurrentSince Jan 1, 2024 Accepting new patients

Locations

1660 W Antelope Dr
Layton, UT 84041
Phone (801) 525-8726

1660 W Antelope Dr
Ste 320
Layton, UT 84041
Phone (801) 820-5414

1750 E 3100 N
Layton, UT 84040
Phone (385) 405-2252

Networks

  • UT PPO D-SNP
  • UT PPO

Interoperability endpoints

  • Direct secure messaging: david.jenks.p1@direct.tannerclinic.nextgenshare.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1482192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1255876777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 N 500 E",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843417800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 N 1700 W",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840418803",
            "telephone_number": "801-773-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKS",
        "first_name": "DAVID",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D., LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-20",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.