Sundance

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

PT010530 Issued in GA

Legal business name

SUNDANCE

Practice address

145 Cox Farm Rd NW
Marietta, GA 30064-5059

Phone

(207) 992-6007

NPI assigned

Nov 23, 2012

Organization subpart

Yes

Parent organization

NOAs reported in NPPES

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

Authorized official

Name

Mrs. Shemily Mathew

Title

PT

Phone

(207) 992-6007

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1353628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353628800000",
    "number": "1629312079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 COX FARM RD NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300645059",
            "telephone_number": "207-992-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 COX FARM RD NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300645059",
            "telephone_number": "207-992-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NO",
        "enumeration_date": "2012-11-23",
        "last_updated": "2012-11-23",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "SHEMILY",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "207-992-6007",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "PT010530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula L Sumple, M.S. CCC-SLP
• Sheila F. Sumpter, CRNA
• Angela Sumrall, MA, LPC
• Sun Pediatrics LLC
• Yuanyue Sun, M.D.
• Lesley Elliece Sunday, M.D.
• Chris Chan Moo Sung
• Denise Sunga
• Sunil K Singh Dental LLC
• Sunny Skies ABA Ga LLC

• Skilled Nursing Facility in Marietta, GA
• Providers in Marietta, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2012; 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.