Individual provider Active NPI

Sean Jeremy Dunker, DPT

  • Physical Therapist
  • Urbana, MD
National Provider Identifier
1083860654
Registry record updated Feb 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22638 Issued in MD
Practice address
3510 Sugarloaf Pkwy
Suite G-02
Urbana, MD 21704-7910
Phone
(301) 874-9200
Fax
(301) 874-9202
NPI assigned
Aug 14, 2008
Last updated
Feb 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 22638 MD Primary

Addresses

Primary practice location

3510 Sugarloaf Pkwy
Suite G-02
Urbana, MD 21704-7910

Mailing address

3510 Sugarloaf Pkwy
Suite G-02
Urbana, MD 21704-7910
Phone (301) 874-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081106000701 MD Practitioner - Physical Therapist in Private Practice 7113086000 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22638MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Physical Therapy & Wellness LLC Physical Therapist CurrentSince Jun 30, 2011 Accepting new patients
Fredericks Sport and Spine Clinic Inc Past Accepting new patients

Locations

3510 Sugarloaf Pkwy
Ste G2
Urbana, MD 21704
Phone (301) 874-9200

3536A Urbana Pike
Urbana, MD 21704
Phone (301) 874-9200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1083860654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 SUGARLOAF PKWY",
            "address_2": "SUITE G-02",
            "city": "URBANA",
            "state": "MD",
            "postal_code": "217047910",
            "telephone_number": "301-874-9200",
            "fax_number": "301-874-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 SUGARLOAF PKWY",
            "address_2": "SUITE G-02",
            "city": "URBANA",
            "state": "MD",
            "postal_code": "217047910",
            "telephone_number": "301-874-9200",
            "fax_number": "301-874-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNKER",
        "first_name": "SEAN",
        "middle_name": "JEREMY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-14",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "22638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.