NPIMap

Organization Active NPI

Lifebridge Sports Medicine and Rehabilitation LLC

Doing business as Lifebridge Health Physical Therapy

  • Rehabilitation Clinic/Center
  • Eldersburg, MD
National Provider Identifier
1265538359
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC
Doing business as
Lifebridge Health Physical Therapy
Practice address
6190 Georgetown Blvd
Eldersburg, MD 21784-6460
Phone
(410) 552-4235
Fax
(410) 552-4248
NPI assigned
Sep 15, 2006
Last updated
Mar 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Authorized official

Name
Elizabeth Gelbaugh
Title
Manager
Phone
(717) 972-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X NU Primary

Addresses

Primary practice location

6190 Georgetown Blvd
Eldersburg, MD 21784-6460

Mailing address

4714 Gettysburg Rd
Legal Dept
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100

Other names 1

  • Lifebridge Health Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100204000732 MD Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 4385787910 14 other NPIs on this enrollment
Practice locations: Owings Mills, MD; Towson, MD; Timonium, MD; Reisterstown, MD; Middle River, MD; Baltimore, MD; Bel Air, MD; Hunt Valley, MD…

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553126400000",
    "number": "1265538359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "address_2": "LEGAL DEPT",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6190 GEORGETOWN BLVD",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846460",
            "telephone_number": "410-552-4235",
            "fax_number": "410-552-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2019-03-21",
        "status": "A",
        "authorized_official_last_name": "GELBAUGH",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifebridge Health Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lifebridge Health Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eldersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.