Sundog Rehabilitation LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1487 Issued in SD

Legal business name

SUNDOG REHABILITATION LLC

Practice address

3064 Covington St
Suite 104
Rapid City, SD 57703-7207

Phone

(605) 787-2719

Fax

(605) 718-4452

NPI assigned

Apr 22, 2011

Organization subpart

No

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

Authorized official

Name

Sarah Pettyjohn, DPTNPI 1366656118

Title

Sole Member

Phone

(605) 787-2719

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Locations

Practitioners 5

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

• Sarah Pettyjohn

  • Physical Therapist
  • Rapid City, SD
  • NPI 1366656118
  Medicare reassignment NPD Authorized official
• Rebecca Lynn Baird, DPT

  • Physical Therapist
  • Rapid City, SD
  • NPI 1518935659
  Medicare reassignment NPD
• Bonnie Catherine Kohl, PT, DPT

  • Physical Therapist
  • Rapid City, SD
  • NPI 1114325230
  Medicare reassignment NPD
• Jennifer Wright, SLP

  • Speech-Language Pathologist
  • Rapid City, SD
  • NPI 1063582492
  Medicare reassignment NPD
• Jessica Johnson

  • Physical Therapist
  • San Francisco, CA
  • NPI 1245389782
  NPD (past)

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448409600000",
    "number": "1285925453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3064 COVINGTON ST",
            "address_2": "SUITE 104",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577037207",
            "telephone_number": "605-787-2719",
            "fax_number": "605-718-4452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3064 COVINGTON ST",
            "address_2": "SUITE 104",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577037207",
            "telephone_number": "605-787-2719",
            "fax_number": "605-718-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDOG REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-22",
        "last_updated": "2015-11-25",
        "status": "A",
        "authorized_official_last_name": "PETTYJOHN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "605-787-2719",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "SD",
            "license": "1487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "S105011",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wesley L Sufficool, DO
• Andrew Sullivan, DPT
• Emily Summers
• Summit Allergy Asthma ENT PLLC
• Beth J Sundahl, PHARMD
• Charice Amber Suomala, CNP
• Surgical Solutions Professional Limited Liability Company
• Willis C Sutliff, M.D.
• Pamela D Sutto, BA
• Brettrick J Sutton, D.C.

• Physical Therapy Clinic/Center in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Physical Therapy Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; 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.