Sundance

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

A1737 Issued in NC

Legal business name

SUNDANCE

Practice address

228 Smith Chapel Road
Mount Olive, NC 28365

Phone

(919) 658-9522

NPI assigned

Nov 19, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Karen Lane, PTA

Title

TPM

Phone

(919) 658-9522

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1760726475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 SMITH CHAPEL ROAD",
            "city": "MOUNT OLIVE",
            "state": "NC",
            "postal_code": "28365",
            "telephone_number": "919-658-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 SMITH CHAPEL ROAD",
            "city": "MOUNT OLIVE",
            "state": "NC",
            "postal_code": "28365",
            "telephone_number": "919-658-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "TPM",
        "authorized_official_telephone_number": "919-658-9522",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "A1737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sovran Senior Living, LLC
• Madeline Stablein
• Darren Edward Stevens, PHARMD
• Doris Stringfield
• Sunbridge Regency - North Carolina, LLC.
• Tiffany Jane Swinson, LCAS-A
• Talton Physician Services PLLC
• The Mat Group, Inc.
• Andrea Thompson
• Megan Tobitt

• All providers in Mount Olive, NC
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.