NPIMap

Organization Active NPI

Sundance Rehab

  • Physical Disabilities Residential Treatment Facility
  • Richmond Hill, GA
National Provider Identifier
1013217140
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
License
5527 Issued in GA
Legal business name
SUNDANCE REHAB
Practice address
64 Miller Dr
Richmond Hill, GA 31324-4843
Phone
(912) 596-5436
NPI assigned
Oct 22, 2010
Last updated
Oct 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Authorized official

Name
Kristin Higdon
Title
Pta Prog. MGR
Phone
(912) 927-0667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X 5527 GA Primary

Addresses

Primary practice location

64 Miller Dr
Richmond Hill, GA 31324-4843

Mailing address

1 Peachtree Dr
Savannah, GA 31419-1200

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1013217140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PEACHTREE DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 MILLER DR",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313244843",
            "telephone_number": "912-596-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "HIGDON",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "PTA PROG. MGR",
        "authorized_official_telephone_number": "912-927-0667"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "GA",
            "license": "5527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.