NPIMap

Organization Active NPI

Red Canyon, LLC

  • Physical Therapist
  • Urbana, MD
National Provider Identifier
1508502204
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RED CANYON, LLC
Practice address
3501 John Simmons St # A203
Urbana, MD 21704-7964
Phone
(301) 882-8382
Fax
(301) 882-8399
NPI assigned
May 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Authorized official

Name
Daniel James Gardner
Title
Owner
Phone
(443) 416-7949

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

3501 John Simmons St # A203
Urbana, MD 21704-7964

Mailing address

3501 John Simmons St # A203
Urbana, MD 21704-7964

National Provider Directory

National Provider Directory
Tax ID family
Red Canyon LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

3501 John Simmons St
#A203
Urbana, MD 21704
Phone (301) 882-8382

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": "1651795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750896000000",
    "number": "1508502204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 JOHN SIMMONS ST # A203",
            "city": "URBANA",
            "state": "MD",
            "postal_code": "217047964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHN SIMMONS ST # A203",
            "city": "URBANA",
            "state": "MD",
            "postal_code": "217047964",
            "telephone_number": "301-882-8382",
            "fax_number": "301-882-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED CANYON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-06",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-416-7949"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 Jun 26, 2025; 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.