NPIMap

Organization Active NPI

Sundance Rehabilitation Agency LLC

  • Rehabilitation Clinic/Center
  • Lebanon, PA
National Provider Identifier
1689901332
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
SUNDANCE REHABILITATION AGENCY LLC
Practice address
1125 Birch Rd
Lebanon, PA 17042-9123
Phone
(717) 273-2103
Fax
(717) 273-2103
NPI assigned
Nov 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Authorized official

Name
Ian Oppel
Title
Coo
Phone
(980) 254-7007

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Rehabilitation Clinic/Center 261QR0400X PA Primary

Addresses

Primary practice location

1125 Birch Rd
Lebanon, PA 17042-9123

Mailing address

101 E State St
Kennett Square, PA 19348-3109
Phone (610) 925-4560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110816000421 PA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 5698683498 Practice locations: Lebanon, PA

Outpatient physical therapy / speech pathology certification: CCN 396849

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SUNDANCE REHABILITATION AGENCY OF PENNSYLVANIA
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Jun 23, 2011
Last certification
Mar 16, 2023
Ownership / control type
Proprietary
Facility address
1125 Birch Road
Lebanon, PA 17042

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Sundance Rehabilitation Agency LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770336000000",
    "number": "1689901332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "610-925-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 BIRCH RD",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170429123",
            "telephone_number": "717-273-2103",
            "fax_number": "717-273-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE REHABILITATION AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-17",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A",
        "authorized_official_last_name": "OPPEL",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "980-254-7007"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.