Individual provider Active NPI

Zachary Jordan Jeffers

  • Nurse Practitioner
  • Provo, UT
National Provider Identifier
1225827843
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9202033-4405 Issued in UT
Practice address
395 W Cougar Blvd Ste 704
Provo, UT 84604-3333
Phone
(801) 357-3242
Fax
(801) 357-3241
NPI assigned
May 1, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9202033-4405 UT Primary
Student in an Organized Health Care Education/Training Program 390200000X 9202033-3102 UT

Addresses

Primary practice location

395 W Cougar Blvd Ste 704
Provo, UT 84604-3333

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

1191 W 1200 S
Springville, UT 84663-5076
Phone (385) 221-1645

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250815003600 UT Practitioner - Nurse Practitioner 8224537352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

395 W Bulldog Blvd
Suite 704
Provo, UT 84604-3333
Phone (801) 357-3242

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9202033-3102UTMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Aug 3, 2025 Accepting new patients
Ihc Health Services, Inc. CurrentSince Aug 3, 2025 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

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

395 W Cougar Blvd
Ste 704
Provo, UT 84604
Phone (801) 357-3242

1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1225827843",
    "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": "395 W COUGAR BLVD STE 704",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043333",
            "telephone_number": "801-357-3242",
            "fax_number": "801-357-3241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1191 W 1200 S",
            "address_purpose": "LOCATION",
            "city": "Springville",
            "state": "UT",
            "postal_code": "846635076",
            "country_code": "US",
            "telephone_number": "385-221-1645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEFFERS",
        "first_name": "ZACHARY",
        "middle_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "9202033-4405",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "UT",
            "license": "9202033-3102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.