Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jeremy D Gilliam, MD

Individual provider Diagnostic Radiology Physician · NPI 1538284153

Dr. Jeremy D Gilliam, MD is a Diagnostic Radiology in Fort Wayne, Indiana. Graduated from Indiana University School of Medicine in 2003, 23 years ago. Practices with Henry County Memorial Hospital, a 152-clinician group and accepts Medicare assignment. Licensed in Indiana, Kentucky and Ohio.

Years since qualifying
23
Trained at
Indiana University School of Medicine
Licensed in
IN, KY, OH
In the registry since
2007
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5001 US Highway 30 W Ste D
Fort Wayne, IN 46818-9701
Phone: (260) 432-4969
Fax: (260) 432-4969
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 01064785A (IN)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence R1044 (KY)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 35.091145 (OH)

Record details

NPI number1538284153
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 20, 2007
Last updated in NPPESJune 20, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolINDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduated 2003 (23 years in practice)
Group practice Henry County Memorial Hospital — 152 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

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