NPIMap

Organization Active NPI

Lifebridge Community Physicians Inc

  • Family Medicine Physician
  • Mount Airy, MD
National Provider Identifier
1114718723
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIFEBRIDGE COMMUNITY PHYSICIANS INC
Practice address
504 E Ridgeville Blvd Ste 110
Mount Airy, MD 21771-5942
Phone
(301) 846-0300
Fax
(410) 601-4938
NPI assigned
May 14, 2025
Last updated
May 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 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
(443) 422-9941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

504 E Ridgeville Blvd Ste 110
Mount Airy, MD 21771-5942

Mailing address

504 E Ridgeville Blvd Ste 110
Mount Airy, MD 21771-5942
Phone (301) 846-0300

Other names 1

  • LifeBridge Potomac Professionals at Mt Airy Other name

National Provider Directory

National Provider Directory
Tax ID family
Lifebridge Community Physicians148 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1747180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1114718723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 E RIDGEVILLE BLVD STE 110",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217715942",
            "telephone_number": "301-846-0300",
            "fax_number": "410-601-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 E RIDGEVILLE BLVD STE 110",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217715942",
            "telephone_number": "301-846-0300",
            "fax_number": "410-601-4938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "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": "443-422-9941"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeBridge Potomac Professionals at Mt Airy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mount Airy, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.