Organization Active NPI

Lifebridge Community Pulmonology, LLC

  • Pulmonary Disease Physician
  • Mount Airy, MD
National Provider Identifier
1174326599
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
LIFEBRIDGE COMMUNITY PULMONOLOGY, LLC
Practice address
713 Midway Ave
Mount Airy, MD 21771-2833
Phone
(410) 484-5686
Fax
(410) 484-6472
NPI assigned
Mar 31, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 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
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

713 Midway Ave
Mount Airy, MD 21771-2833

Mailing address

713 Midway Ave
Mount Airy, MD 21771-2833
Phone (410) 484-5686

Other names 1

  • Lung & Sleep Centers of MD at Midway Other name

National Provider Directory

National Provider Directory
Tax ID family
Lifebridge Community Pulmonology LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743379200000",
    "number": "1174326599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 MIDWAY AVE",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217712833",
            "telephone_number": "410-484-5686",
            "fax_number": "410-484-6472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 MIDWAY AVE",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217712833",
            "telephone_number": "410-484-5686",
            "fax_number": "410-484-6472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PULMONOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "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": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lung & Sleep Centers of MD at Midway",
            "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 Mar 31, 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.