NPIMap

Organization Active NPI

Lifebridge Community Physicians Inc

  • Cardiovascular Disease Physician
  • Ellicott City, MD
National Provider Identifier
1114728870
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
LIFEBRIDGE COMMUNITY PHYSICIANS INC
Practice address
4801 Dorsey Hall Dr
Ellicott City, MD 21042-7766
Phone
(410) 469-4000
Fax
(410) 469-4074
NPI assigned
Mar 20, 2025
Last updated
Mar 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 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
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

4801 Dorsey Hall Dr
Ellicott City, MD 21042-7766

Mailing address

4801 Dorsey Hall Dr
Ellicott City, MD 21042-7766
Phone (410) 469-4000

Other names 1

  • Woodholme Cardiology at Dorsey Hall 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 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": "1742428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1114728870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427766",
            "telephone_number": "410-469-4000",
            "fax_number": "410-469-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427766",
            "telephone_number": "410-469-4000",
            "fax_number": "410-469-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-20",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "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": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodholme Cardiology at Dorsey Hall",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.