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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
6955001-1205 | UT | Allopathic & Osteopathic Physicians |
Street Address |
1551 RENAISSANCE TOWNE DR SUITE 460 |
City | BOUNTIFUL |
State | UT |
Zip Code | 84010-7667 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 84010 |
Taxonomy Code | 208VP0014X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pain Medicine |
Specialization | Interventional Pain Medicine |
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. |
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 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on CANYON RIDGE PAIN AND SPINE PC.
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.