Canyon Pain and Wellness PLLC
NPI 1164013900ActiveOrganization· Nurse Anesthetist, Certified Registered· Glendale, AZ
Nurse Anesthetist, Certified Registered in Glendale, Arizona, registered in NPPES in February 2021. The authorized official on file is Antony K. Waweru, CRNA, Administrator. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1164013900 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 2, 2021 |
| Last updated in NPPES | Feb 6, 2026 |
| Certified by provider | Feb 6, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Anesthetist, Certified Registered Primary | 367500000X | — | — |
| Registered Nurse, Pain Management | 163WP0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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