Canyon Pain and Spine

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CANYON PAIN AND SPINE

Practice address

4566 E Inverness Ave Ste 108
Mesa, AZ 85206-4633

Phone

(480) 561-5000

Fax

(480) 984-4066

NPI assigned

Apr 24, 2024

Last updated

Apr 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kirk George Bowden

Title

Owner and Physician

Phone

(480) 889-0255

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Canyon Pain and Spine

  • Interventional Pain Medicine Physician
  • Glendale, AZ
  • NPI 1104590512

  3870992647

  Same PAC ID
• Canyon Pain and Spine

  • Durable Medical Equipment & Medical Supplies
  • Buckeye, AZ
  • NPI 1467292938

  3870992647

  Same PAC ID
• Canyon Pain and Spine

  • Pain Medicine Physician
  • Mesa, AZ
  • NPI 1518547769

  3870992647

  Same PAC ID
• Canyon Pain and Spine

  • Interventional Pain Medicine Physician
  • Mesa, AZ
  • NPI 1770257180

  3870992647

  Same PAC ID
• Canyon Pain and Spine

  • Durable Medical Equipment & Medical Supplies
  • Tempe, AZ
  • NPI 1801574785

  3870992647

  Same PAC ID
• Canyon Pain and Spine

  • Durable Medical Equipment & Medical Supplies
  • Gilbert, AZ
  • NPI 1962180844

  3870992647

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1144076829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4566 E INVERNESS AVE STE 108",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064633",
            "telephone_number": "480-561-5000",
            "fax_number": "480-984-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4566 E INVERNESS AVE STE 108",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064633",
            "telephone_number": "480-561-5000",
            "fax_number": "480-984-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON PAIN AND SPINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "BOWDEN",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER AND PHYSICIAN",
        "authorized_official_telephone_number": "480-889-0255"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Canup
• Caryssa Canuto
• Canyon Family Medicine PLLC (Canyon Family Medicine)
• Canyon Hematology Oncology
• Canyon Lakes Dental Group and Orthodontics, LLP (Canyon Lakes Dental and Orthodontics)
• Canyon Pain and Spine
• Canyon Pain and Spine
• Canyon Pain Surgery Center
• Canyon Pain Surgery Center
• Canyon Pediatrics, Inc

• Durable Medical Equipment & Medical Supplies in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Durable Medical Equipment & Medical Supplies in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.