Individual provider Active NPI

Charles Morris Cribbs III, PA-C

  • Physician Assistant
  • Tampa, FL
National Provider Identifier
1942877162
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA91142756 Issued in FL
Practice address
10210 Windhorst Rd
Tampa, FL 33619-7828
Phone
(352) 362-4602
NPI assigned
Jun 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA91142756 FL Primary

Addresses

Primary practice location

10210 Windhorst Rd
Tampa, FL 33619-7828

Mailing address

502 S Fremont Ave Apt 433
Tampa, FL 33606-4300
Phone (352) 362-4602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240510003367 MD Practitioner - Physician Assistant 8527409366 Reassigns benefits to 2 organizations
I20240510003377 DC Practitioner - Physician Assistant 8527409366 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Urgent Care LLCGroup PAC ID 9335303155, 300 clinicians

Practice addresses (Care Compare)

11915 Georgia Ave
Wheaton, MD 20902-2065
Phone (301) 942-4505

3064 Waldorf Market PL
Waldorf, MD 20603-4871
Phone (301) 932-5960

37767 Market Dr
Charlotte Hall, MD 20622-3188
Phone (301) 290-1499

45870 E Run Dr
Lexington Park, MD 20653-4362
Phone (240) 895-8630

500 Charles St
La Plata, MD 20646-5931
Phone (410) 451-1800

6401 America Blvd
Hyattsville, MD 20782-2357
Phone (301) 276-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA91142756FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Urgent Care LLC CurrentSince May 5, 2024 Accepting new patients
Medstar Urgent Care, LLC CurrentSince May 5, 2024 Accepting new patients
Medstar Urgent Care LLC CurrentSince May 5, 2024 Accepting new patients
CRH MD Management LLC CurrentSince Aug 1, 2024 Accepting new patients
CRH MD Management LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

590 Lanier Ave W
Fayetteville, GA 30214

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

14421 Baltimore Ave
Laurel, MD 20707
Phone (240) 786-6684

11804 Reisterstown Rd
Reisterstown, MD 21136
Phone (410) 870-5094

14090 Hg Trueman Rd
Ste 1300
Solomons, MD 20688
Phone (410) 394-2800

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1942877162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 S FREMONT AVE APT 433",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336064300",
            "telephone_number": "352-362-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10210 WINDHORST RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336197828",
            "telephone_number": "352-362-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIBBS",
        "first_name": "CHARLES",
        "middle_name": "MORRIS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA91142756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.