NPIMap

Organization Active NPI

Red Canyon, LLC

  • Physical Therapist
  • Frederick, MD
National Provider Identifier
1952768673
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RED CANYON, LLC
Practice address
801 Toll House Ave
Suite H-3
Frederick, MD 21701-4564
Phone
(240) 575-9260
Fax
(240) 575-9380
NPI assigned
Jan 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Authorized official

Name
Mr. Daniel James Gardner, MPT
Title
Managing Partner
Phone
(443) 416-7949

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

801 Toll House Ave
Suite H-3
Frederick, MD 21701-4564

Mailing address

200 Business Center Dr
Reisterstown, MD 21136-1230
Phone (443) 416-7949

Other practice location 1

9093 Ridgefield Dr Ste 201
Frederick, MD 21701-6712
Phone (410) 855-4855

Other practice location 2

110 Baughmans Ln Ste 160
Frederick, MD 21702-4946
Phone (240) 651-1335

Other practice location 3

12916 Conamar Dr Ste 103
Hagerstown, MD 21742-2760
Phone (301) 665-3731

Other practice location 4

3501 John Simmons St Ste A203
Urbana, MD 21704-7964
Phone (301) 882-8382

Other practice location 5

21 Mellor Ave
Catonsville, MD 21228-5106
Phone (443) 251-4088

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160331002359 MD Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1052618352 Receives reassigned benefits from 17 practitioners
5 other NPIs on this enrollment
Practice locations: Columbia, MD; Frederick, MD; Hagerstown, MD; Urbana, MD

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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

801 Toll House Ave
Ste H3
Frederick, MD 21701
Phone (240) 575-9260

128 Duella Dr
Ste B
Inwood, WV 25428
Phone (304) 309-3550

5801 Williamsport Pike
Ste 200
Martinsburg, WV 25404
Phone (304) 244-5442

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1952768673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BUSINESS CENTER DR",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361230",
            "telephone_number": "443-416-7949",
            "fax_number": "410-747-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 TOLL HOUSE AVE",
            "address_2": "SUITE H-3",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014564",
            "telephone_number": "240-575-9260",
            "fax_number": "240-575-9380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9093 Ridgefield Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217016712",
            "country_code": "US",
            "telephone_number": "410-855-4855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Baughmans Ln Ste 160",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024946",
            "country_code": "US",
            "telephone_number": "240-651-1335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12916 Conamar Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217422760",
            "country_code": "US",
            "telephone_number": "301-665-3731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3501 John Simmons St Ste A203",
            "address_purpose": "LOCATION",
            "city": "Urbana",
            "state": "MD",
            "postal_code": "217047964",
            "country_code": "US",
            "telephone_number": "301-882-8382",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 Mellor Ave",
            "address_purpose": "LOCATION",
            "city": "Catonsville",
            "state": "MD",
            "postal_code": "212285106",
            "country_code": "US",
            "telephone_number": "443-251-4088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RED CANYON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-26",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "443-416-7949",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.