Individual provider Active NPI

Jamie Lynn Rebman, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Murray, UT
National Provider Identifier
1033145339
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
7610500-1205 Issued in UT
Practice address
5121 Cottonwood Rd
Suite 610
Murray, UT 84107
Phone
(801) 507-3630
Fax
(801) 507-3630
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 42497 CO
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 7610500-1205 UT Primary

Addresses

Primary practice location

5121 Cottonwood Rd
Suite 610
Murray, UT 84107

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111026000333 UT Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 7719940345 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42497COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
University of Utah Adult Services Current Accepting new patients
Ihc Health Services Inc CurrentSince Jan 27, 2020 Accepting new patients
University of Utah Adult Services CurrentSince Apr 1, 2017 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 27, 2020 Accepting new patients
University of Utah Adult Services CurrentSince Apr 1, 2017 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

5121 S Cottonwood St
Ste 610
Salt Lake City, UT 84107
Phone (801) 507-3630

5171 S Cottonwood St
Ste 610
Salt Lake City, UT 84107
Phone (801) 507-3630

2000 Circle of Hope Dr
#2E
Slc, UT 84112
Phone (801) 585-0100

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1033145339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 COTTONWOOD RD",
            "address_2": "SUITE 610",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "84107",
            "telephone_number": "801-507-3630",
            "fax_number": "801-507-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBMAN",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "42497",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "UT",
            "license": "7610500-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.