NPIMap

Organization Active NPI

Lifebridge Community Physicians, Inc

  • Internal Medicine Physician
  • Westminster, MD
National Provider Identifier
1386045441
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LIFEBRIDGE COMMUNITY PHYSICIANS, INC
Practice address
1011 Baltimore Blvd
Westminster, MD 21157-7055
Phone
(410) 601-9355
NPI assigned
Sep 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MD Primary

Addresses

Primary practice location

1011 Baltimore Blvd
Westminster, MD 21157-7055

Mailing address

1011 Baltimore Blvd
Westminster, MD 21157-7055
Phone (410) 601-9355

Other names 1

  • Dr Thomas Vento Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110627000318 MD Part B Supplier - Clinic/Group Practice 3678751468 Receives reassigned benefits from 358 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Lifebridge Community Physicians Inc148 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1386045441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BALTIMORE BLVD",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211577055",
            "telephone_number": "410-601-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BALTIMORE BLVD",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211577055",
            "telephone_number": "410-601-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "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": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Thomas Vento",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dr Thomas Vento",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 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.