NPIMap

Organization Active NPI

Sundance Rehabilitation

  • Assisted Living Facility
  • Newnan, GA
National Provider Identifier
1831468792
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
SLP007514 Issued in GA
Legal business name
SUNDANCE REHABILITATION
Practice address
110 Edgeworth Rd
Newnan, GA 30263-6916
Phone
(770) 683-6854
Fax
(770) 252-0886
NPI assigned
Dec 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Authorized official

Name
Sheree Rudder, PTA
Title
Therapy Program Manager
Phone
(770) 683-6854

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X SLP007514 GA Primary

Addresses

Primary practice location

110 Edgeworth Rd
Newnan, GA 30263-6916

Mailing address

110 Edgeworth Rd
Newnan, GA 30263-6916
Phone (770) 683-6854

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.

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": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324512000000",
    "number": "1831468792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 EDGEWORTH RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302636916",
            "telephone_number": "770-683-6854",
            "fax_number": "770-252-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EDGEWORTH RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302636916",
            "telephone_number": "770-683-6854",
            "fax_number": "770-252-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-22",
        "last_updated": "2011-12-22",
        "status": "A",
        "authorized_official_last_name": "RUDDER",
        "authorized_official_first_name": "SHEREE",
        "authorized_official_title_or_position": "THERAPY PROGRAM MANAGER",
        "authorized_official_telephone_number": "770-683-6854",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "SLP007514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.