Lifebridge Community Physicians, Inc

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

LIFEBRIDGE COMMUNITY PHYSICIANS, INC

Practice address

4801 Dorsey Hall Dr
Suite 220
Ellicott City, MD 21042-7766

Phone

(410) 469-4904

NPI assigned

Aug 15, 2013

Organization subpart

No

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

Authorized official

Name

Mary Wright-Sisk

Title

Director

Phone

(443) 422-9941

Specialties & licenses 1

Addresses

Other names 1

• Dr Jonathan Safren Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vincent Anthony Giminaro, DO

  • Pulmonary Disease Physician
  • Bel Air, MD
  • NPI 1730179722
  NPD

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1285067017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR",
            "address_2": "SUITE 220",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427766",
            "telephone_number": "410-469-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR",
            "address_2": "SUITE 220",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427766",
            "telephone_number": "410-469-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-15",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "WRIGHT-SISK",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-422-9941"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Jonathan Safren",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dr Jonathan Safren",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lifebridge Community Gastroenterology, LLC
• Lifebridge Community Physicians Inc
• Lifebridge Community Physicians Inc
• Lifebridge Community Physicians Inc
• Lifebridge Community Physicians Inc
• Lifebridge Medical Associates, LLC
• Lifebridge Orthopedic Specialists, LLC
• Marissa Lightkep, MS, LGPC
• Leigh A Lightner, LGMFT
• Like Home, Inc.

• All providers in Ellicott City, MD
• Cardiovascular Disease Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.