West Valley Pain Specialists, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

WEST VALLEY PAIN SPECIALISTS, LLC

Practice address

18301 N 79TH Ave Ste F170
Glendale, AZ 85308-6338

Phone

(602) 325-2020

Fax

(602) 714-7274

NPI assigned

Sep 29, 2021

Organization subpart

No

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

Authorized official

Name

Antony Waweru, CRNA

Title

Owner

Phone

(602) 325-2020

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1346912276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18301 N 79TH AVE STE F170",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086338",
            "telephone_number": "602-325-2020",
            "fax_number": "602-714-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18301 N 79TH AVE STE F170",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086338",
            "telephone_number": "602-325-2020",
            "fax_number": "602-714-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VALLEY PAIN SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "WAWERU",
        "authorized_official_first_name": "ANTONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-325-2020",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Physical Medicine & Rehabilitation Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.