NPIMap

Organization Active NPI

Lifebridge Community Physicians Inc

  • Family Medicine Physician
  • Laurel, MD
National Provider Identifier
1407656192
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIFEBRIDGE COMMUNITY PHYSICIANS INC
Practice address
8871 Gorman Rd
Laurel, MD 20723-5877
Phone
(301) 498-3150
Fax
(410) 601-8886
NPI assigned
Mar 13, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

8871 Gorman Rd
Laurel, MD 20723-5877

Mailing address

8871 Gorman Rd
Laurel, MD 20723-5877
Phone (301) 498-3150

Other names 1

  • LifeBridge Potomac Professionals at Laurel Other name

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

NPI Registry JSON

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

{
    "created_epoch": "1741824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741824000000",
    "number": "1407656192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8871 GORMAN RD",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207235877",
            "telephone_number": "301-498-3150",
            "fax_number": "410-601-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8871 GORMAN RD",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207235877",
            "telephone_number": "301-498-3150",
            "fax_number": "410-601-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-13",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeBridge Potomac Professionals at Laurel",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.