Lifebridge Community Physicians, Inc
Organization Active NPI Family Medicine Physician · Sparks, MD
NPI 1134545841 · NPPES record last updated Aug 27, 2021
Key facts
- NPI
- 1134545841
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- LIFEBRIDGE COMMUNITY PHYSICIANS, INC
- Practice address
- 913 Ridgebrook Rd
Sparks, MD 21152-9455 - Phone
- (410) 601-9355
- NPI assigned
- Mar 6, 2014
- Organization subpart
- No
Authorized official
- Name
- Mary Wright-Sisk
- Title
- Director
- Phone
- (443) 422-9941
Corporate family (same tax ID) 24
Practitioners 9
-
Jeffrey M. Banker, M.D.
-
Myeisha Furr, NP
-
Melecia K Helwig-Henson, PA-C
-
Athol W Morgan, M.D., M.H.S.
-
Mariah Muse, CRNP
-
Dionne Davidia Oliver, M.D.
-
Adrian Adam Sarzynski, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110627000318 | MD | Part B Supplier - Clinic/Group Practice | 3678751468 |
Receives reassigned benefits from 358 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Lifebridge Community Physicians Inc
Locations
940 Madison Ave
Fl 1
Baltimore, MD 21201
Phone (410) 382-1050
913 Ridgebrook Rd
Sparks, MD 21152
Phone (410) 472-1113
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | MD | Yes |
Addresses
Primary practice location
913 Ridgebrook Rd
Sparks, MD 21152-9455
Mailing address
913 Ridgebrook Rd
Suite 312
Sparks, MD 21152-9455
Other names
- Dr Cyrus Hamidi
Other providers in Sparks, MD
- Aarika Lee
- Matthew Joseph Lepito
- Madelyn Levasseur
- Rhiannon Levenson
- Aaliyah Lewis
- Hsiu Chin Lin
- Lisa M Savoie, MD, LLC
- Jasmine Lopez
- Nadia Lowe
- Kayla Lyles
All providers in Sparks, MD · Family Medicine Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.