Active NPI
Alex Wade Childs, PA-C
- Physician Assistant
- Grantsville, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 11261845-1206
- 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, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
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
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 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 55294 | CA | MD | General Practice Dentistry |
| 11261845-1206 | UT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Siskiyou Hospital, Inc. | Current | Accepting new patients | |
| Tusk Genetics LLC | Current | Accepting new patients | |
| Benjamin J Krogh DO PC | Family Medicine | Past | 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
- achild16@yourcarecommunity.org
- 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.
-
- Medical Physician Assistant
- Grantsville, UT
- NPI 1982564746
-
- Family Medicine Physician
- Tooele, UT
- NPI 1073512364
-
dba Fairchild Medical Center
- Critical Access Hospital
- Yreka, CA
- NPI 1093892275
-
dba Mountain West Medical Center
- General Acute Care Hospital
- Tooele, UT
- NPI 1124090659
-
dba Grantsville Medical Clinic
- Family Medicine Physician
- Grantsville, UT
- NPI 1972696425
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mountain West Medical Center
- General Acute Care Hospital
- Tooele, UT
- NPI 1124090659
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2025; 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.