CHARLES G PRIBBLE MD NPI 1245349042

NPI Information

  • NPI: 1245349042
  • Provider Name: CHARLES G PRIBBLE, MD
  • Classification: Pediatrics - 2080P0203X
  • Specialization: Pediatric Critical Care Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 100 N MEDICAL DR
    SALT LAKE CITY, UT
    ZIP 84113
  • Phone: (801) 993-9551

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NPI Details

Charles G Pribble, MD is a pediatric critical care medicine pediatrics in Salt Lake City, UT. The provider is 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. Charles G Pribble, MD NPI is 1245349042. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

100 N MEDICAL DR
SALT LAKE CITY, UT
ZIP 84113-103
Phone: (801) 993-9551
Fax: (801) 733-5872

The NPI 1245349042 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/29/2006 and was last updated on 12/12/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207L00000XAnesthesiology173715-1205UTAHNo
22080P0203XPediatricsPediatric Critical Care Medicine173715-1205UTAHYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1002085560OTHERUTAHFIRST HEALTH
2174281OTHERUTAHDESERET MUTUAL
3105131800MEDICAIDWYOMING
4870280408PR2OTHERUTAHEDUCATORS MUTUAL
529927OTHERUTAHPEHP
6PR00809OTHERUTAHMOLINA
7QM0000049539OTHERUTAHALTIUS
8107006307101OTHERUTAHIHC
92000040OTHERUTAHUNITED HEALTHCARE
10401765MEDICAIDMONTANA
11002967300MEDICAIDIDAHO
128920OTHERUTAHHEALTHY U

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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