NPIMap

Organization Active NPI

Sun Dial Manor Inc

  • Assisted Living Facility
  • Bristol, SD
National Provider Identifier
1104030717
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
10739 Issued in SD
Legal business name
SUN DIAL MANOR INC
Practice address
410 2ND St S
Bristol, SD 57219-0337
Phone
(605) 492-3615
Fax
(605) 492-3616
NPI assigned
May 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Peggy L Pearson
Title
Administrator
Phone
(605) 492-3615

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 10739 SD Primary

Addresses

Primary practice location

410 2ND St S
Bristol, SD 57219-0337

Mailing address

PO Box 337
Bristol, SD 57219-0337
Phone (605) 492-3615

Other identifiers 1

IdentifierTypeStateIssuer
9570060MedicaidSD

National Provider Directory

National Provider Directory
Tax ID family
Sun Dial Manor Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104030717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "BRISTOL",
            "state": "SD",
            "postal_code": "572190337",
            "telephone_number": "605-492-3615",
            "fax_number": "605-492-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 2ND ST S",
            "city": "BRISTOL",
            "state": "SD",
            "postal_code": "572190337",
            "telephone_number": "605-492-3615",
            "fax_number": "605-492-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN DIAL MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "605-492-3615"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SD",
            "license": "10739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9570060",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.