NPIMap

Organization Active NPI

Lifebridge Orthopedic Specialists, LLC

  • Neurological Surgery Physician
  • Randallstown, MD
National Provider Identifier
1194515239
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
LIFEBRIDGE ORTHOPEDIC SPECIALISTS, LLC
Practice address
5415 Old Court Rd Ste 504
Randallstown, MD 21133-5170
Phone
(410) 601-4417
Fax
(410) 601-7138
NPI assigned
May 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

5415 Old Court Rd Ste 504
Randallstown, MD 21133-5170

Mailing address

5415 Old Court Rd Ste 504
Randallstown, MD 21133-5170
Phone (410) 601-4417

Other names 1

  • LifeBridge Neurosciences at Old Court Other name

National Provider Directory

National Provider Directory
Tax ID family
Lifebridge Neurosciences at Old Court15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

5415 Old Court Rd
Ste 504
Randallstown, MD 21133
Phone (410) 601-5597

NPI Registry JSON

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773360000000",
    "number": "1194515239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 OLD COURT RD STE 504",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335170",
            "telephone_number": "410-601-4417",
            "fax_number": "410-601-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 OLD COURT RD STE 504",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335170",
            "telephone_number": "410-601-4417",
            "fax_number": "410-601-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE ORTHOPEDIC SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-12",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "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": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeBridge Neurosciences at Old Court",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; 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.