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CHARLES G PRIBBLE MD
NPI 1245349042
Pediatrics - Pediatric Critical Care Medicine in Salt Lake City, UT

Active since August 29, 2006PECOS Enrolled
100 N MEDICAL DR, SALT LAKE CITY, UT 84113(801) 993-9551(801) 733-5872 Get Directions Write a Review

NPPES record last updated: December 12, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 12, 2024, Dec 1, 2021 (2 updates tracked since 2021).

About Charles G Pribble Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES G PRIBBLE MD (NPI 1245349042) is an individual pediatric critical care medicine provider in Salt Lake City, Utah, licensed in Utah (173715-1205) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245349042
Entity TypeIndividualMale
Primary Taxonomy2080P0203X
Provider Legal NameCHARLES G PRIBBLECredential: MD
Location Address100 N MEDICAL DRSalt Lake City, UT 84113-1103
Mailing Address100 N Medical DrSalt Lake City, UT 84113-1103
Phone(801) 993-9551
Fax(801) 733-5872
Sole ProprietorNo
Enumeration DateAugust 29, 2006
Last NPPES UpdateDecember 12, 20242 updates tracked since enumeration
NPPES CertifiedDecember 12, 2024
✔ NPI 1245349042 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0203X
License✔ Licensed in UT · 173715-1205
Definition
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Also ListedAnesthesiologyTaxonomy 207L00000X · License 173715-1205 (UT)
100 N MEDICAL DR, Salt Lake City, UT 84113
Open in Google Maps ↗

Other Identifiers 12

Other002085560UT · First Health
Other174281UT · Deseret Mutual
Medicaid105131800WY
Other870280408PR2UT · Educators Mutual
Other29927UT · Pehp
OtherPR00809UT · Molina
OtherQM0000049539UT · Altius
Other107006307101UT · Ihc
Other2000040UT · United Healthcare
Medicaid401765MT
Medicaid002967300ID
Other8920UT · Healthy U

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Charles G Pribble Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Charles Pribble reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pediatric Anesthesiologists Inc
Same address
Anesthesiology
100 N MEDICAL DR
Salt Lake City, UT 84113
  • Reassigned Medicare billing, Utah enrollment
  • 48 clinicians in this Medicare group
NPI 1417965799 (888) 249-4598
University Of Utah Pediatric Acuity Care
0.1 mi
Pediatric Emergency Medicine
100 N MARIO CAPECCHI DR
Salt Lake City, UT 84113
  • Reassigned Medicare billing, Utah enrollment
  • 202 clinicians in this Medicare group
NPI 1538523675 (801) 587-6336

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LISA ANN RUNYON CPNP
Nurse Practitioner (Pediatrics)
100 N MEDICAL DR, TRAUMA SERVICES
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-2993
KATHERINE A HUGHES OT
Occupational Therapist
100 N MEDICAL DR
SLC, UT 84113
Salt Lake County (801) 588-2000
LINDA M LAMBERT A.P.R.N.
Nurse Practitioner
100 N MEDICAL DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-1000
MS. ANN A. K. KAMP APRN
Nurse Practitioner (Neonatal)
100 N MEDICAL DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-1000
UNIVERSITY OF UTAH GENERAL PEDIATRICS
Pediatrics
100 N MEDICAL DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 588-2233
DR. TYSON STUART HORKLEY M.D.
Pediatrics
100 N MEDICAL DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 267-1855
MS. DEBRA ANN TEMPLIN NP
Nurse Practitioner (Pediatrics, Critical Care)
100 N MEDICAL DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-2447
BONNIE ANN CLAY CPNP
Nurse Practitioner (Pediatrics)
100 N MEDICAL DR, 2800
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-5566

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Pribble's NPI number?

The NPI number for Charles Pribble is 1245349042. It was assigned to this individual provider in the NPPES registry on August 29, 2006.

Where is Charles Pribble located?

Charles Pribble practices at 100 N Medical Dr, Salt Lake City, UT 84113. The listed phone number is (801) 993-9551.

What is Charles Pribble's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Is Charles Pribble enrolled in Medicare?

Yes. Charles Pribble is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Charles Pribble's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Charles Pribble reassigns Medicare benefits to 2 organizations: Pediatric Anesthesiologists Inc (Salt Lake City, UT) and University Of Utah Pediatric Acuity Care (Salt Lake City, UT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Charles Pribble's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Charles Pribble accept?

Health plans from Select Health list Charles Pribble as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Charles Pribble was last updated on December 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.