Canyon Ridge Chiropractic, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

369867-1202 Issued in UT

Legal business name

CANYON RIDGE CHIROPRACTIC, INC.

Practice address

520 Medical Dr Ste 200
Bountiful, UT 84010-8928

Phone

(801) 292-4400

Fax

(844) 308-6615

NPI assigned

May 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jason Larry Smith, DC, MS, DACNB

Title

Doctor of Chiropractic Medicine

Phone

(801) 292-4400

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 2

• Spine Brain Rehab Doing business as
• Utah Spine and Brain Doing business as

Locations

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1427262195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MEDICAL DR STE 200",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108928",
            "telephone_number": "801-292-4400",
            "fax_number": "844-308-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MEDICAL DR STE 200",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108928",
            "telephone_number": "801-292-4400",
            "fax_number": "844-308-6615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON RIDGE CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "LARRY",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC MEDICINE",
        "authorized_official_telephone_number": "801-292-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, MS, DACNB"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "369867-1202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "52908255401001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP",
            "identifier": "1427262195",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1558391169",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spine Brain Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Utah Spine and Brain",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phillip Campbell
• Christopher Canale, MD
• Rebecca Canfield
• Gwen R Cannon
• Hyrum M Cannon, DDS
• Canyon Ridge Pain and Spine PC
• Lisa Cappelli
• Gina Markos Capps, CPNP
• Jennifer Rigby Cardinal, PHD, BCBA
• Kelci D Cardinal

• Chiropractor in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Chiropractor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.