NPIMap

Organization Active NPI

Sunshine Terrance

  • Rehabilitation Clinic/Center
  • Logan, UT
National Provider Identifier
1417347113
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
92879094201 Issued in UT
Legal business name
SUNSHINE TERRANCE
Practice address
209 W 300 N
Logan, UT 84321-3809
Phone
(435) 716-8535
NPI assigned
Feb 2, 2015
Last updated
Feb 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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

Authorized official

Name
Dr. Brock Keith Christensen, OTR/LNPI 1780070367
Title
Occupational Therapist
Phone
(435) 512-9071

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 92879094201 UT
Multi-Specialty Clinic/Center 261QM1300X 92879094201 UT
Rehabilitation Clinic/Center 261QR0400X 92879094201 UT Primary
Skilled Nursing Facility 314000000X 92879094201 UT

Addresses

Primary practice location

209 W 300 N
Logan, UT 84321-3809

Mailing address

1277 E 100 S
Logan, UT 84321-4974
Phone (435) 512-9071

Other identifiers 2

IdentifierTypeStateIssuer
92879094201MedicaidUT
9287909-4201MedicaidUT

National Provider Directory

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": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422835200000",
    "number": "1417347113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1277 E 100 S",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843214974",
            "telephone_number": "435-512-9071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W 300 N",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843213809",
            "telephone_number": "435-716-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE TERRANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-02",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "BROCK",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "435-512-9071",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "UT",
            "license": "92879094201",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "UT",
            "license": "92879094201",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "UT",
            "license": "92879094201",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "UT",
            "license": "92879094201",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92879094201",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9287909-4201",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.