NPIMap

Organization Active NPI

Lifebridge Community Physicians Inc

  • Psychiatry Physician
  • Baltimore, MD
National Provider Identifier
1497476451
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
LIFEBRIDGE COMMUNITY PHYSICIANS INC
Practice address
2434 W Belvedere Ave
Baltimore, MD 21215-5267
Phone
(410) 601-9355
Fax
(410) 601-4458
NPI assigned
Sep 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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) 623-8926

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2434 W Belvedere Ave
Baltimore, MD 21215-5267

Mailing address

2434 W Belvedere Ave
Baltimore, MD 21215-5267
Phone (410) 601-9355

Other names 1

  • LBH Behavioral Health Levindale Other name

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 4

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": "1662595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1497476451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2434 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155267",
            "telephone_number": "410-601-9355",
            "fax_number": "410-601-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155267",
            "telephone_number": "410-601-9355",
            "fax_number": "410-601-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-07",
        "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": "443-623-8926"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LBH Behavioral Health Levindale",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.