NPIMap

Organization Active NPI

Lifebridge Cardiology of Parkville, LLC

  • Cardiovascular Disease Physician
  • Baltimore, MD
National Provider Identifier
1578956108
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
LIFEBRIDGE CARDIOLOGY OF PARKVILLE, LLC
Practice address
2700 Quarry Lake Dr
Suite 160
Baltimore, MD 21209-3742
Phone
(410) 601-9355
NPI assigned
Mar 6, 2015
Organization subpart
Yes
Parent organization
LIFEBRIDGE COMMUNITY PHYSICIANS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Authorized official

Name
Mary Wright-Sisk
Title
Director
Phone
(443) 422-9941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X MD Primary

Addresses

Primary practice location

2700 Quarry Lake Dr
Suite 160
Baltimore, MD 21209-3742

Mailing address

2700 Quarry Lake Dr
Suite 160
Baltimore, MD 21209-3742
Phone (410) 601-9355

Other names 1

  • Dr Jerald Insel Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lifebridge Cardiology of Parkville LLC4 organizations share this tax ID, including this one
Part of
Lifebridge Community Physicians Inc

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1578956108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 QUARRY LAKE DR",
            "address_2": "SUITE 160",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093742",
            "telephone_number": "410-601-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 QUARRY LAKE DR",
            "address_2": "SUITE 160",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093742",
            "telephone_number": "410-601-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE CARDIOLOGY OF PARKVILLE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFEBRIDGE COMMUNITY PHYSICIANS, INC",
        "enumeration_date": "2015-03-06",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A",
        "authorized_official_last_name": "WRIGHT-SISK",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-422-9941"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Jerald Insel",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dr Jerald Insel",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 31, 2021; 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.