Craig Aaron Packham, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

51058218002 Issued in UT

Practice address

2356 N 400 E
Ste 102
Tooele, UT 84074

Phone

(435) 833-9180

Fax

(435) 833-9177

NPI assigned

Sep 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

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 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tooele Orthopedics and Sports Medicine SpecialistsGroup PAC ID 0941279566, 4 clinicians

Mountain West Family Practice LLCGroup PAC ID 6406813070, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain West Medical Center Hospital, Tooele, UT, CCN 460014

Merit-based Incentive Payment System (MIPS)

Final score

77.74 of 100Reported as group

Quality

63.3

Promoting interoperability

98

Improvement activities

40

Cost

64.15

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Mountain West Family Practice LLC

  • Family Medicine Physician
  • Tooele, UT
  • NPI 1770581605
  Medicare reassignment Care Compare group
• Tooele Orthopedics & Sports Medicine Specialists

  • Orthopaedic Surgery Physician
  • Tooele, UT
  • NPI 1467581173
  Medicare reassignment Care Compare group
• Senior Health LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Woods Cross, UT
  • NPI 1134721228
  Medicare reassignment NPD
• Western Medical Consultants

  • Internal Medicine Physician
  • Draper, UT
  • NPI 1790175073
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tooele Hospital Corporation

  • General Acute Care Hospital
  • Tooele, UT
  • NPI 1124090659
  Care Compare affiliation

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

{
    "created_epoch": "1157760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1104920354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2356 N 400 E",
            "address_2": "STE 102",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "84074",
            "telephone_number": "435-833-9180",
            "fax_number": "435-833-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2356 N 400 E",
            "address_2": "STE 102",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "84074",
            "telephone_number": "435-833-9180",
            "fax_number": "435-833-9177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2356 N 400 E Ste 201",
            "address_purpose": "LOCATION",
            "city": "Tooele",
            "state": "UT",
            "postal_code": "840743409",
            "country_code": "US",
            "telephone_number": "435-882-2350",
            "fax_number": "435-880-2039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACKHAM",
        "first_name": "CRAIG",
        "middle_name": "AARON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-09",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "51058218002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D4703",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald Scott Overy, PHARMD.
• Lance Owens, MD
• Zoey Owens
• Oxygen for You, Inc.
• Gabrielle Pack, PHARMD
• Pagnani Physical Therapy
• Eric Lee Palmer, DDS
• Deanna Michelle Parish
• Karyn Parker
• Odbayar Jigjidsuren Parry, LCSW

• Medical Physician Assistant in Tooele, UT
• Providers in Tooele, UT by specialty
• Medical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.