Individual provider Active NPI

Jeffery Hillam, MD

  • Emergency Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1750841110
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
12701251-1205 Issued in UT
Practice address
333 N 300 W
Salt Lake City, UT 84103-1215
Phone
(801) 463-7415
NPI assigned
Mar 21, 2019
Last updated
Aug 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT219035 PA
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X 12701251-1205 UT Primary
Emergency Medicine Physician 207P00000X HS000102L PA

Addresses

Primary practice location

333 N 300 W
Salt Lake City, UT 84103-1215

Mailing address

333 N 300 W
Salt Lake City, UT 84103-1215
Phone (801) 463-7415

Other practice location 1

1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone (850) 431-7910

Other practice location 2

1300 Miccosukee Rd
Tallahassee, FL 32308-5054
Phone (850) 431-7910

Other practice location 3

205 S Front St
Harrisburg, PA 17104
Phone (717) 231-8775

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
I20220923001396 UT Practitioner - Emergency Medicine 7719213313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Miami, LM Miller School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3451 W 5600
Roy, UT 84067-9112
Phone (801) 896-5600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
HS000102LPAMDEmergency Medicine Physician
12701251-1205UTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Integrated Care, LLC Emergency Medicine CurrentSince Jul 1, 2022 Accepting new patients

Locations

630 Medical Dr
North Salt Lake, UT 84010
Phone (801) 292-6231

2690 N 600 W
Pleasant View, UT 84414
Phone (801) 786-7911

3451 W 5600 S
Roy, UT 84067
Phone (801) 896-5600

333 N 300 W
Salt Lake City, UT 84103
Phone (801) 463-7415

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111

2675 W Taylorsville Blvd
Taylorsville, UT 84129
Phone (801) 982-0050

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 562-4210

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1750841110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N 300 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841031215",
            "telephone_number": "801-463-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N 300 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841031215",
            "telephone_number": "801-463-7415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Miccosukee Rd",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323085054",
            "country_code": "US",
            "telephone_number": "850-431-7910",
            "fax_number": "850-431-8251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 Miccosukee Rd",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323085054",
            "country_code": "US",
            "telephone_number": "850-431-7910",
            "fax_number": "850-431-8251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 S Front St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "17104",
            "country_code": "US",
            "telephone_number": "717-231-8775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILLAM",
        "first_name": "JEFFERY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT219035",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "12701251-1205",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "HS000102L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.