Lifebridge Community Physicians Inc

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

D0060491 Issued in MD

Legal business name

LIFEBRIDGE COMMUNITY PHYSICIANS INC

Practice address

10084 Reisterstown Rd
Suite 300a
Owings Mills, MD 21117

Phone

(667) 219-6313

Fax

(443) 815-4706

NPI assigned

May 17, 2018

Last updated

Mar 19, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary R Wright-Sisk, MD

Title

Director

Phone

(443) 422-9941

Specialties & licenses 4

Addresses

Other names 1

• LifeBridge Health Sports Medicine Other name

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth M Atkinson, PA-C

  • Physician Assistant
  • Randallstown, MD
  • NPI 1740805779
  NPD
• Eugene C Taylor II, MD

  • Family Medicine Physician
  • Laurel, MD
  • NPI 1861557035
  NPD
• Jack Ibrahim Haj Obeid, M. D.

  • Critical Care Medicine (Anesthesiology) Physician
  • Tampa, FL
  • NPI 1104808054
  NPD
• David Eun Kim, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Hanover, PA
  • NPI 1063726461
  NPD

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1093205841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10084 REISTERSTOWN RD",
            "address_2": "SUITE 300A",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "21117",
            "telephone_number": "667-219-6313",
            "fax_number": "443-815-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10084 REISTERSTOWN RD",
            "address_2": "SUITE 300A",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "21117",
            "telephone_number": "667-219-6313",
            "fax_number": "443-815-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-17",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "WRIGHT-SISK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-422-9941",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MD",
            "license": "D0060491",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "MD",
            "license": "D0060491",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MD",
            "license": "D0060491",
            "primary": true
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "MD",
            "license": "D0060491",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeBridge Health Sports Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Lifebridge Anesthesia Associates, LLC (Lifebridge Anesthesia Associates at SCOB)
• Lifebridge Community Pediatrics, LLC
• Lifebridge Community Physicians Inc
• Lifebridge Community Physicians Inc
• Lifebridge Community Physicians Inc
• Lifebridge Community Physicians Inc
• Lifebridge Community Physicians Inc
• Lifebridge Community Physicians Inc

• Sports Medicine (Orthopaedic Surgery) Physician in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.