NPIMap

Organization Active NPI

Sundance Rehabilitation Agency, Inc.

Doing business as SunDance Maryland Rehabilitation Agency

  • Rehabilitation Clinic/Center
  • Columbia, MD
National Provider Identifier
1093760928
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
N/A
Legal business name
SUNDANCE REHABILITATION AGENCY, INC.
Doing business as
SunDance Maryland Rehabilitation Agency
Practice address
6336 Cedar LN
Columbia, MD 21044-3897
Phone
(410) 531-3402
Fax
(410) 531-3402
NPI assigned
May 22, 2006
Organization subpart
Yes
Parent organization
SUNDANCE REHABILITATION CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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

Authorized official

Name
Sue Gwyn
Title
President Director
Phone
(617) 646-5593

Specialties & licenses 1

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

Addresses

Primary practice location

6336 Cedar LN
Columbia, MD 21044-3897

Mailing address

101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604

Other names 1

  • SunDance Maryland Rehabilitation Agency Doing business as

National Provider Directory

National Provider Directory
Part of
Sundance Rehab Corp

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

135 Hoyt St
Athens, GA 30601
Phone (706) 549-0031

2280 Highway 29 N
Newnan, GA 30265
Phone (770) 253-8833

3001 W Blue Starr Dr
Claremore, OK 74017
Phone (918) 342-1651

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1093760928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SUN AVE NE",
            "address_2": "COMPLIANCE DEPARTMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094373",
            "telephone_number": "505-468-5604",
            "fax_number": "505-468-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6336 CEDAR LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443897",
            "telephone_number": "410-531-3402",
            "fax_number": "410-531-3402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE REHABILITATION AGENCY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNDANCE REHABILITATION CORPORATION",
        "enumeration_date": "2006-05-22",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "GWYN",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "PRESIDENT DIRECTOR",
        "authorized_official_telephone_number": "617-646-5593"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SunDance Maryland Rehabilitation Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; 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.