SUNDOG REHABILITATION LLC (NPI# 1285925453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285925453 |
| Entity Type | Organization |
| Organization Name | SUNDOG REHABILITATION LLC |
| Practice Address |
3064 Covington St Suite 104 Rapid City SD 57703-7207 |
| Practice Telephone | 6057872719 |
| Practice Fax Number | 6057184452 |
| Mailing Telephone | 6057872719 |
| Mailing Fax Number | 6057184452 |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2015-11-25 |
| Authorized Official Name | SARAH PETTYJOHN (SOLE MEMBER) |
| Authorized Official Telephone | 6057872719 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
1487 | SD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE PTAN | S105011 | 01 |
| Street Address |
3064 COVINGTON ST SUITE 104 |
| City | RAPID CITY |
| State | SD |
| Zip Code | 57703-7207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366656118 | Sarah Pettyjohn | Physical Therapist | 3064 Covington St, Suite 104, Rapid City, SD 57703-7207 | 2007-05-10 |
| 1720466501 | Kendra Marie Webster | Physical Therapist | 3064 Covington St, Suite 104, Rapid City, SD 57703-7207 | 2015-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376197533 | Richard Brady Perdue | Dentist | 2606 Elderberry Blvd, Rapid City, SD 57703 | 2019-07-26 |
| 1700125259 | Rapid City Regional Hospital, Inc. | Pharmacy | 1906 Lombardy Drive, Suite 102, Rapid City, SD 57703 | 2013-02-04 |
| 1689912875 | Rocky Mountain Holdings LLC | Ambulance | 4025 Lacroix Ct, Rapid City, SD 57703 | 2013-01-22 |
| 1083900310 | Olivia Bingaman | Nurse Practitioner | 1760 Centre St Ste B, Rapid City, SD 57703 | 2011-06-24 |
| 1770878944 | Tom Dale Iverson | Pharmacist | 1415 Eglin St., Rapid City, SD 57703 | 2011-06-15 |
| 1770944498 | Richard Scott Wiley | Counselor | 4951 Hansen Ln, Rapid City, SD 57703-0147 | 2016-03-08 |
| 1811271331 | Kelli Jo Birdsall | Speech-Language Pathologist | 4840 Homestead St, Rapid City, SD 57703-0194 | 2011-10-03 |
| 1932658762 | Lyndsay Farnsworth | Registered Nurse | 4840 Homestead St, Rapid City, SD 57703-0194 | 2016-09-21 |
| 1790953198 | Michele Ann Solano | Occupational Therapist | 1221 Aurora Dr, Rapid City, SD 57703-0198 | 2008-02-19 |
| 1902204894 | Delain Kay Johnson | Counselor | 1501 Centre St, Suite 106, Rapid City, SD 57703-3002 | 2014-12-09 |
| Find all providers in zip 57703 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083151468 | Milestones Pediatric Physical Therapy | Clinic/Center | 960 Nicole St, Rapid City, SD 57701-7047 | 2017-01-24 |
| 1386036119 | Betina K Basso | Clinic/Center | 13621 Neck Yoke Rd, Rapid City, SD 57702-7324 | 2015-03-03 |
| 1083616536 | Hart Physical Therapy Inc | Clinic/Center | 50 Minnesota St, Suite 2, Rapid City, SD 57701-6217 | 2005-08-15 |
| 1457823403 | Regional Health Physicians, Inc. | Clinic/Center | 1635 Caregiver Circle, Rapid City, SD 57702-8529 | 2018-12-31 |
| 1831660844 | Rapid City Regional Hospital, Inc. | Clinic/Center | 1635 Caregiver Circle, Rapid City, SD 57702-8529 | 2018-12-17 |
| 1205104254 | Dynamic Kids Physical Therapy, LLC | Clinic/Center | 2411 Arrow St, Rapid City, SD 57702-4303 | 2011-12-06 |
| 1780886275 | Black Hills Healing Arts Inc | Clinic/Center | 3618 Canyon Lake Dr, Ste. 111, Rapid City, SD 57702-1027 | 2007-06-05 |
| 1366568743 | High Plains Physical Therapy Associates Inc | Clinic/Center | 614 East Blvd, Rapid City, SD 57701 | 2007-03-21 |
| 1740398833 | Rapid City Physical Therapy, Inc | Clinic/Center | 1110 W Omaha St Ste 3, Rapid City, SD 57701-8097 | 2006-08-28 |
| 1760442099 | Neurosurgical & Spinal Surgery Associates, P.C. | Clinic/Center | 4141 5th St, Rapid City, SD 57701-6021 | 2006-03-23 |
| Find all providers in RAPID CITY | ||||
| City | RAPID CITY |
| Zip Code | 57703 |
Please comment or provide details below to improve the information on SUNDOG REHABILITATION LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.