Canyon Ambulatory Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

OSC2285 Issued in AZ

Legal business name

CANYON AMBULATORY SURGERY CENTER, LLC

Practice address

6036 N 19TH Ave
Suite 100
Phoenix, AZ 85015-2106

Phone

(602) 589-8000

Fax

(602) 249-8084

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer Boyd Baldock

Title

Officer and Authorized Officials

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Other identifiers 1

Listed as

Canyon Surgery CenterCCN 03C0001224

Medicare certification status

ActiveFrom the Provider of Services file

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.

• Ryan B Golub, D.P.M.

  • Podiatrist
  • Phoenix, AZ
  • NPI 1285635888
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676160000000",
    "number": "1689755928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6036 N 19TH AVE",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152106",
            "telephone_number": "602-589-8000",
            "fax_number": "602-249-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6036 N 19TH AVE",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152106",
            "telephone_number": "602-589-8000",
            "fax_number": "602-249-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-02-12",
        "certification_date": "2023-02-12",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIALS",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC2285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "479437",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia E Cantu, OTR
• Eduardo Saldana Cantu, PHD
• Kayla Cantu, RN FNP-C
• Thomas P Canty, MD
• Canuhearwell LLC (ABC Hearing aids)
• Canyon Arizona Home Care & Hospice LLC (Canyon Home Care & Hospice)
• Canyon Care Transportation LLC.
• Canyon Health Centers LLC
• Canyon Hills Family Dentistry LLC (Canyon Hills Family Dentistry)
• Canyon Medical Logistics LLC

• Ambulatory Surgical Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.