NPIMap

Organization Active NPI

Canyon View Medical Group LLC

  • Pediatrics Physician
  • Payson, UT
National Provider Identifier
1386836112
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CANYON VIEW MEDICAL GROUP LLC
Practice address
15 South 1000 East, Suite 100
Payson, UT 84651
Phone
(801) 465-9480
NPI assigned
Aug 15, 2007
Last updated
Aug 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Authorized official

Name
Mr. Aaron Lowe
Title
Practice Administrator
Phone
(801) 798-7301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

15 South 1000 East, Suite 100
Payson, UT 84651

Mailing address

325 W Center St
Spanish Fork, UT 84660-2060
Phone (801) 798-7301

Other names 1

  • Payson Pediatrics Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031205000226 UT Part B Supplier - Clinic/Group Practice 9739084351 Receives reassigned benefits from 33 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salem, UT; Santaquin, UT; Spanish Fork, UT; Springville, UT; Mapleton, UT

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D1062167Utah Valley Pediatrics-Payson15 S 1000 E, Ste 200, Payson, UT 84651Certificate of waiverDec 6, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533772800000",
    "number": "1386836112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W CENTER ST",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846602060",
            "telephone_number": "801-798-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SOUTH 1000 EAST, SUITE 100",
            "city": "PAYSON",
            "state": "UT",
            "postal_code": "84651",
            "telephone_number": "801-465-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON VIEW MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2018-08-09",
        "status": "A",
        "authorized_official_last_name": "LOWE",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "801-798-7301",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Payson Pediatrics",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Payson Pediatrics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Payson, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.