NPIMap

Organization Active NPI

Lifebridge Sports Medicine & Rehabilitation, LLC

  • Speech-Language Pathologist
  • Westminster, MD
National Provider Identifier
1245018886
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
LIFEBRIDGE SPORTS MEDICINE & REHABILITATION, LLC
Practice address
41 Magna Way Ste 140
Westminster, MD 21157-3073
Phone
(443) 487-6614
NPI assigned
Sep 15, 2023
Last updated
Sep 15, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SELECT MEDICALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Tarvin
Title
Vice President
Phone
(717) 972-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X NU Primary

Addresses

Primary practice location

41 Magna Way Ste 140
Westminster, MD 21157-3073

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325

National Provider Directory

National Provider Directory
Tax ID family
Lifebridge Sports and Rehabilitation LLC29 organizations share this tax ID, including this one
Part of
Select Medical Corporation

Other organizations with this tax ID 28

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

View all 28

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1245018886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MAGNA WAY STE 140",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211573073",
            "telephone_number": "443-487-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE SPORTS MEDICINE & REHABILITATION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SELECT MEDICAL",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.