NPIMap

Organization Active NPI

Lifebridge Orthopedic Specialists, LLC

  • Neurological Surgery Physician
  • Ellicott City, MD
National Provider Identifier
1528858677
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
LIFEBRIDGE ORTHOPEDIC SPECIALISTS, LLC
Practice address
4801 Dorsey Hall Dr Ste 220
Ellicott City, MD 21042-7749
Phone
(410) 601-4417
Fax
(410) 601-7138
NPI assigned
May 12, 2025
Last updated
May 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 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
Neurological Surgery Physician 207T00000X Primary

Addresses

Primary practice location

4801 Dorsey Hall Dr Ste 220
Ellicott City, MD 21042-7749

Mailing address

4801 Dorsey Hall Dr Ste 220
Ellicott City, MD 21042-7749
Phone (410) 601-4417

Other names 1

  • LifeBridge Neurosciences at Dorsay Hall Other name

National Provider Directory

National Provider Directory
Tax ID family
Lifebridge Neurosciences at Old Court15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747008000000",
    "number": "1528858677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR STE 220",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427749",
            "telephone_number": "410-601-4417",
            "fax_number": "410-601-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR STE 220",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427749",
            "telephone_number": "410-601-4417",
            "fax_number": "410-601-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE ORTHOPEDIC SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "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": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeBridge Neurosciences at Dorsay Hall",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.