NPIMap

Organization Active NPI

Lifebridge Community Physicians Inc

  • Otolaryngology Physician
  • Frederick, MD
National Provider Identifier
1073401972
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
LIFEBRIDGE COMMUNITY PHYSICIANS INC
Practice address
4991 New Design Rd Ste 103
Frederick, MD 21703-7342
Phone
(443) 289-3459
Fax
(443) 289-3488
NPI assigned
Jun 27, 2025
Last updated
Jun 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Authorized official

Name
Mary Rebecca Wright-Sisk
Title
Director
Phone
(434) 229-9414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

4991 New Design Rd Ste 103
Frederick, MD 21703-7342

Mailing address

4991 New Design Rd Ste 103
Frederick, MD 21703-7342
Phone (443) 289-3459

Other names 1

  • LifeBridge Health ENT, Sinus & Allergy Center at New Design Other name

National Provider Directory

National Provider Directory
Tax ID family
Lifebridge Community Phyinc148 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750982400000",
    "number": "1073401972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4991 NEW DESIGN RD STE 103",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037342",
            "telephone_number": "443-289-3459",
            "fax_number": "443-289-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4991 NEW DESIGN RD STE 103",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217037342",
            "telephone_number": "443-289-3459",
            "fax_number": "443-289-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A",
        "authorized_official_last_name": "WRIGHT-SISK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "REBECCA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "434-229-9414"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeBridge Health ENT, Sinus & Allergy Center at New Design",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jun 27, 2025; 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.