CANYON RIDGE PAIN AND SPINE PC


Address: 1551 Renaissance Towne Dr, Suite 460, Bountiful, UT 84010-7667
Phone: 8012054116

CANYON RIDGE PAIN AND SPINE PC (NPI# 1376821587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1376821587
Entity Type Organization
Organization Name CANYON RIDGE PAIN AND SPINE PC
Practice Address 1551 Renaissance Towne Dr
Suite 460
Bountiful
UT 84010-7667
Practice Telephone 8012054116
Practice Fax Number 4359869368
Mailing Telephone 8012054116
Mailing Fax Number 4359869368
Enumeration Date 2011-07-22
Last Update Date 2011-07-22
Authorized Official Name DR. RAUL KEM WESTON (PRESIDENT)
Authorized Official Telephone 8012054116
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208VP0014X Pain Medicine
Specialization: Interventional Pain Medicine
6955001-1205 UT Allopathic & Osteopathic Physicians

Office Location

Street Address 1551 RENAISSANCE TOWNE DR
SUITE 460
City BOUNTIFUL
State UT
Zip Code 84010-7667

Providers in the same location

NPI Name Taxonomy Address Enumeration
1548261431 Curtis Brian Jolley Physical Therapist 1551 Renaissance Towne Dr, Ste 350, Bountiful, UT 84010-7667 2005-08-02
1346776127 Kelli R Loveland Audiologist 1551 Renaissance Towne Dr, Bountiful, UT 84010 2017-05-11
1235505587 Children's Dentistry Dentist 1551 Renaissance Towne Dr, Ste 540, Bountiful, UT 84010-7667 2015-08-20
1811370836 Melanie Chamberlain Physical Therapist 1551 Renaissance Towne Dr, Ste 350, Bountiful, UT 84010-7667 2015-07-08
1306236492 Jared J Tyson Md PC Specialist 1551 Renaissance Towne Dr, Suite 400, Bountiful, UT 84010-7667 2015-01-28
1033522933 Jill Freitas Calderwood Audiologist 1551 Renaissance Towne Dr, Bountiful, UT 84010-7667 2014-06-09
1326475831 Michelle Horne Specialist/Technologist 1551 Renaissance Towne Dr, Suite 420, Bountiful, UT 84010-7667 2013-09-28
1194098020 Jordan Scott Carver Pharmacist 1551 Renaissance Towne Dr, #104, Bountiful, UT 84010-7667 2012-02-23
1790066124 Stuart Chase Sondrup Physical Therapist 1551 Renaissance Towne Dr, Ste 350, Bountiful, UT 84010-7667 2011-08-30
1629374582 Dawn Muhlestein Physician Assistant 1551 Renaissance Towne Dr, Suite 400, Bountiful, UT 84010-7667 2011-02-09
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225699192 Jessyca K Willie Behavior Technician 415 S. Medical Drive Suite D101, Bountiful, UT 84010 2019-06-21
1336634344 Shanna Joy Jaggers Social Worker 2333 S 200 E, Bountiful, UT 84010 2018-06-22
1447773171 Live Life Alarms Emergency Response System Companies 640 South 500 West, Bountiful, UT 84010 2017-07-25
1902328842 Hailey Embley Behavior Technician 415 Medical Drive D 101, Bountiful, UT 84010 2017-07-12
1508318031 Beverly Nielsen Psychologist 1001 Lakeview Drive, Bountiful, UT 84010 2016-11-01
1295287720 Samantha Oslund Speech-Language Pathologist 415 Medical Dr Ste B102, Bountiful, UT 84010 2016-11-01
1750748273 Jeremy Clark Morris Dentist 59 W 1600 N, Suite 110, Bountiful, UT 84010 2016-01-28
1629464706 Shane James Speech-Language Pathologist 425 Medical Dr Ste 122, Bountiful, UT 84010 2015-04-15
1891186102 Kenton Francis Social Worker 1355 North Main Street #1, Bountiful, UT 84010 2015-02-09
1205233855 Modern Dental Professionals - Utah, PC Dentist 24 S. 500 West, #a, Bountiful, UT 84010 2014-11-25
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Taxonomy Information

Taxonomy Code 208VP0014X
Grouping Allopathic & Osteopathic Physicians
Classification Pain Medicine
Specialization Interventional Pain Medicine

Taxonomy Definition

Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1972862605 Intermountain Pain Management and Injury, Inc Pain Medicine 6575 S Redwood Rd, St 201, Taylorsville, UT 84123-5688 2012-05-15
1285958439 Advanced Spine Pain Specialists Pain Medicine 286 N Gateway Dr Ste 201, Providence, UT 84332-5603 2010-03-17
1619907490 Kyle Shigeru Matsumura Pain Medicine 6750 S Highland Drive, Ste 100, Cottonwood Heights, UT 84121 2006-07-04
1326665829 Wasatch Wellness Center LLC Pain Medicine 1215 S 1680 W, Orem, UT 84058-4939 2020-06-30
1689226391 Utah Intermountain Pain Management Pain Medicine 8822 S Redwood Rd Ste 113, West Jordan, UT 84088-9341 2019-07-12
1568909836 Glacier Peak Pain Care Pllc Pain Medicine 1407 N 2000 W, Clinton, UT 84015-8562 2017-01-25
1073959714 Wasatch Sports, Spine & Pain Treatment Center Pllc Pain Medicine 680 E Main St, 202, Lehi, UT 84043-2241 2013-05-21
1841531340 Wasatch Pain Solutions, PC Pain Medicine 661 W 10600 S, South Jordan, UT 84095-8524 2013-03-07
1063721850 Alta Pain Physicians, Pllc Pain Medicine 11333 S 1000 E, #102, Sandy, UT 84094-5428 2010-09-28
1861643330 Craig William Davis Pain Medicine 3181 W 9000 So, West Jordan, UT 84088 2008-10-02
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Competitor

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City BOUNTIFUL
Zip Code 84010

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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