NPIMap

Organization Active NPI

Lifebridge Community Physicians, Inc

  • Internal Medicine Physician
  • Pikesville, MD
National Provider Identifier
1497094809
Registry record updated Nov 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LIFEBRIDGE COMMUNITY PHYSICIANS, INC
Practice address
4000 Old Court Rd
Suite 300
Pikesville, MD 21208-2800
Phone
(410) 486-6300
Fax
(410) 486-7200
NPI assigned
Feb 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2016

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

Authorized official

Name
Mary R. Wright-Sisk
Title
Director
Phone
(410) 701-4439

Specialties & licenses 1

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

Addresses

Primary practice location

4000 Old Court Rd
Suite 300
Pikesville, MD 21208-2800

Mailing address

4000 Old Court Rd
Suite 300
Pikesville, MD 21208-2800
Phone (410) 486-6300

Other names 1

  • Drs. Kroopnick & Sherman 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

Locations

2629 Riva Rd
Ste 112
Annapolis, MD 21401
Phone (410) 266-1000

Practitioners & affiliated clinicians

Practitioners 7

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": "1360022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479772800000",
    "number": "1497094809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 OLD COURT RD",
            "address_2": "SUITE 300",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212082800",
            "telephone_number": "410-486-6300",
            "fax_number": "410-486-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 OLD COURT RD",
            "address_2": "SUITE 300",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212082800",
            "telephone_number": "410-486-6300",
            "fax_number": "410-486-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-05",
        "last_updated": "2016-11-22",
        "status": "A",
        "authorized_official_last_name": "WRIGHT-SISK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-701-4439"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drs. Kroopnick & Sherman",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; 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.