NPIMap

Organization Active NPI

Sundance Rehabilitation Agency LLC

  • Rehabilitation Clinic/Center
  • Claremore, OK
National Provider Identifier
1073662607
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
SUNDANCE REHABILITATION AGENCY LLC
Practice address
3001 W Blue Starr Dr
Claremore, OK 74017-2544
Phone
(918) 283-1257
Fax
(410) 480-7169
NPI assigned
Jan 10, 2007
Last updated
Apr 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Authorized official

Name
Ian OppelNPI 1245002708
Title
Coo
Phone
(980) 254-7007

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X NU Primary

Addresses

Primary practice location

3001 W Blue Starr Dr
Claremore, OK 74017-2544

Mailing address

200 Northpointe Cir Ste 302
Seven Fields, PA 16046-7861
Phone (724) 831-5044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120726000427 OK Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 5698683498 Practice locations: Claremore, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073662607. Details of each certification follow.

  • CCN 376631 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 376631

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SUNDANCE REHABILITATION AGENCY OF OKLAHOMA
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Mar 18, 2013
Last certification
Dec 29, 2021
Ownership / control type
Proprietary
Facility address
3001 W Blue Starr Dr
Claremore, OK 74017

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Sundance Rehabilitation Agency LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the 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": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743724800000",
    "number": "1073662607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NORTHPOINTE CIR STE 302",
            "city": "SEVEN FIELDS",
            "state": "PA",
            "postal_code": "160467861",
            "telephone_number": "724-831-5044",
            "fax_number": "610-612-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 W BLUE STARR DR",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740172544",
            "telephone_number": "918-283-1257",
            "fax_number": "410-480-7169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE REHABILITATION AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A",
        "authorized_official_last_name": "OPPEL",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "980-254-7007"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

Verify at the official NPI Registry.