Individual provider Active NPI

Alex Wade Childs, PA-C

  • Physician Assistant
  • Grantsville, UT
National Provider Identifier
1447768718
Registry record updated Nov 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11261845-1206 Issued in UT
Practice address
822 E Main St Ste 7
Grantsville, UT 84029-2501
Phone
(435) 884-3578
NPI assigned
Jan 19, 2018
Last updated
Nov 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2025

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 11261845-1206 UT Primary

Addresses

Primary practice location

822 E Main St Ste 7
Grantsville, UT 84029-2501

Mailing address

798 S Adams Ave
Grantsville, UT 84029-4904
Phone (435) 228-8310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, UT2 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
I20180420002392 CA Practitioner - Physician Assistant 8426311671 Reassigns benefits to 1 organization
I20190606000542 UT Practitioner - Physician Assistant 8426311671 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tooele Clinic CorpGroup PAC ID 6800700873, 63 clinicians

Practice addresses (Care Compare)

2321 N 400
Suite 300
Tooele, UT 84074-3440
Phone (435) 833-9180

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.71 of 100Reported as group
Quality
91.38
Promoting interoperability
100
Improvement activities
40
Cost
77.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55294CAMDGeneral Practice Dentistry
11261845-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Siskiyou Hospital, Inc. CurrentSince Mar 17, 2018 Accepting new patients
Tusk Genetics LLC CurrentSince Nov 22, 2025 Accepting new patients
Benjamin J Krogh DO PC Family Medicine PastSince Nov 24, 2025 Accepting new patients

Locations

444 Bruce St
Yreka, CA 96097
Phone (530) 841-6256

475 Bruce St
Yreka, CA 96097
Phone (530) 842-3507

Interoperability endpoints

  • Direct secure messaging: achild16@yourcarecommunity.org
  • Direct secure messaging: alex.childs.1@1562.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763769600000",
    "number": "1447768718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "798 S ADAMS AVE",
            "city": "GRANTSVILLE",
            "state": "UT",
            "postal_code": "840294904",
            "telephone_number": "435-228-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 E MAIN ST STE 7",
            "city": "GRANTSVILLE",
            "state": "UT",
            "postal_code": "840292501",
            "telephone_number": "435-884-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDS",
        "first_name": "ALEX",
        "middle_name": "WADE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-19",
        "last_updated": "2025-11-22",
        "certification_date": "2025-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "11261845-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grantsville, UT

Sources for this page

Verify at the official NPI Registry.