NPIMap

Organization Active NPI

Prospine, LLC

Doing business as canyon chiropractic

  • Point of Service
  • Phoenix, AZ
National Provider Identifier
1013113976
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
5775 Issued in AZ
Legal business name
PROSPINE, LLC
Doing business as
canyon chiropractic
Practice address
1107 E Bell Rd
Suite 14
Phoenix, AZ 85022-2691
Phone
(602) 866-3500
Fax
(602) 866-3510
NPI assigned
Jun 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Dylan Foster, D.C.NPI 1780706317
Title
Owner
Phone
(602) 866-3500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 5775 AZ Primary

Addresses

Primary practice location

1107 E Bell Rd
Suite 14
Phoenix, AZ 85022-2691

Mailing address

1107 E Bell Rd
Suite 14
Phoenix, AZ 85022-2691
Phone (602) 866-3500

Other names 1

  • canyon chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

1107 E Bell Rd
Ste 14
Phoenix, AZ 85022
Phone (602) 866-3500

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013113976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 E BELL RD",
            "address_2": "SUITE 14",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850222691",
            "telephone_number": "602-866-3500",
            "fax_number": "602-866-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 E BELL RD",
            "address_2": "SUITE 14",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850222691",
            "telephone_number": "602-866-3500",
            "fax_number": "602-866-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "DYLAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-866-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "AZ",
            "license": "5775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "canyon chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.