Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Chad Ryan Rebo, PA-C

Individual provider Physician Assistant · NPI 1164856886

Chad Ryan Rebo, PA-C is a Physician Assistant in Salt Lake City, Utah. Graduated from University of Utah School of Medicine in 2013, 13 years ago. Practices with St Johns Lutheran Hospital Inc, a 35-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Montana and Utah.

Years since qualifying
13
Trained at
University of Utah School of Medicine
Licensed in
MT, UT
In the registry since
2013
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

340 E 100 S
Salt Lake City, UT 84111-1702
Phone: (801) 428-3500
Fax: (801) 322-2831
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 805 Sunset Blvd, Conrad, MT 59425-1717 — (406) 271-3211
  • 802 2nd St Se, Cut Bank, MT 59427-3329 — (406) 873-2251
  • 6 13th Ave E, Polson, MT 59860-5315 — (406) 883-5680
  • 640 Park Ave, Shelby, MT 59474-1663 — (406) 434-3207

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MED-PAC-LIC-41920 (MT)
Physician Assistant Taxonomy 363A00000X · Licence 8776901-1206 (UT)

Record details

NPI number1164856886
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 29, 2013
Last updated in NPPESFebruary 19, 2024
Certification dateFebruary 19, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated 2013 (13 years in practice)
Group practice St Johns Lutheran Hospital Inc — 35 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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