Canyon Pain and Spine
NPI 1104590512ActiveOrganization· Pain Medicine, Interventional Pain Medicine· Glendale, AZ
Pain Medicine, Interventional Pain Medicine in Glendale, Arizona, registered in NPPES in August 2021. The authorized official on file is Kirk George Bowden, DO, Owner. Enrolled in Medicare as dme supplier - physician - anesthesiology.
Overview
| NPI | 1104590512 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 9, 2021 |
| Last updated in NPPES | Aug 9, 2021 |
| Certified by provider | Aug 9, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pain Medicine, Interventional Pain Medicine Primary | 208VP0014X | — | — |
| Anesthesiology | 207L00000X | — | — |
| Anesthesiology, Pain Medicine | 207LP2900X | — | — |
| Pain Medicine, Pain Medicine | 208VP0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Anesthesiology (AZ) |
|---|
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