Lifebridge Community Physicians, Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

LIFEBRIDGE COMMUNITY PHYSICIANS, INC

Doing business as

Dr Michelle Morganti

Practice address

1401 Pulaski Hwy
Suite M
Edgewood, MD 21040-1398

Phone

(410) 601-9355

NPI assigned

Jun 23, 2014

Organization subpart

No

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

Authorized official

Name

Joel Suldan

Title

Vice President

Phone

(410) 601-5121

Specialties & licenses 1

Addresses

Other names 1

• Dr Michelle Morganti Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403481600000",
    "number": "1467867044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 PULASKI HWY",
            "address_2": "SUITE M",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210401398",
            "telephone_number": "410-601-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 PULASKI HWY",
            "address_2": "SUITE M",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210401398",
            "telephone_number": "410-601-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-23",
        "status": "A",
        "authorized_official_last_name": "SULDAN",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "410-601-5121"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Michelle Morganti",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Blandine Mafo
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• Obstetrics & Gynecology Physician in Edgewood, MD
• Providers in Edgewood, MD by specialty
• Obstetrics & Gynecology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; 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.