Alex Wade Childs, PA-C
Individual provider Active NPI Physician Assistant · Grantsville, UT
NPI 1447768718 · NPPES record last updated Nov 22, 2025
Key facts
- NPI
- 1447768718
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 11261845-1206 (UT)
- Practice address
- 822 E Main St Ste 7
Grantsville, UT 84029-2501 - Phone
- (435) 884-3578
- NPI assigned
- Jan 19, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- 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 Corp
Practice addresses (Care Compare)
2321 N 400
Suite 300
Tooele, UT 84074-3440
Phone (435) 833-9180
Hospital & facility affiliations
- Mountain West Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.71 of 100
- Quality
- 91.38
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.67
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180420002392 | CA | Practitioner - Physician Assistant | 8426311671 | Reassigns benefits to 1 organization |
| I20190606000542 | UT | Practitioner - Physician Assistant | 8426311671 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- 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
475 Bruce St
Yreka, CA 96097
Phone (530) 842-3507
444 Bruce St
Yreka, CA 96097
Phone (530) 841-6256
Interoperability endpoints
- achild16@yourcarecommunity.org
- alex.childs.1@1562.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 11261845-1206 | UT | Yes |
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
Other providers in Grantsville, UT
- Jared Thomas Brown
- Eileen Michelle Buriek
- Abigail Burnette
- Sydney Busico
- Haeven Cerroni
- Tony L. Cloward
- Benjamin Alexander Cluff
- Alisha Cogar
- Robert Brian Cragun
- Coulten D'Arnall
All providers in Grantsville, UT · Physician Assistant in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.