Canyon Pain Surgery Center

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

CANYON PAIN SURGERY CENTER

Practice address

4540 E Baseline Rd Ste 117
Mesa, AZ 85206-4617

Phone

(480) 561-0446

Fax

(480) 608-4762

NPI assigned

Nov 11, 2024

Organization subpart

No

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

Authorized official

Name

Ryan Gibb, MDNPI 1326366832

Title

Owner and Physician

Phone

(480) 561-5000

Specialties & licenses 1

Addresses

Tax ID family

Canyon Pain Surgery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Canyon Pain Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
  • NPI 1972217180
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan Gibb, M.D.

  • Pain Medicine Physician
  • Gilbert, AZ
  • NPI 1326366832

  Anesthesiology

  NPD Authorized official

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1245054816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 E BASELINE RD STE 117",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064617",
            "telephone_number": "480-561-0446",
            "fax_number": "480-608-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 E BASELINE RD STE 117",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064617",
            "telephone_number": "480-561-0446",
            "fax_number": "480-608-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON PAIN SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "GIBB",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER AND PHYSICIAN",
        "authorized_official_telephone_number": "480-561-5000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 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 and Spine
• Canyon Pain Surgery Center
• Canyon Pediatrics, Inc
• Canyon Taxi L.L.C.
• Canyonbehavior Health
• Lienhoan Cao

• Anesthesiology Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.