NPIMap

Organization Active NPI

Lifebridge Community Physicians, Inc

Doing business as Advanced Cardiology of Carroll County

  • Cardiovascular Disease Physician
  • Westminster, MD
National Provider Identifier
1609150242
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
D68612 Issued in MD
Legal business name
LIFEBRIDGE COMMUNITY PHYSICIANS, INC
Doing business as
Advanced Cardiology of Carroll County
Practice address
826 Washington Rd
Suite 215
Westminster, MD 21157-5750
Phone
(410) 876-9111
Fax
(410) 857-3345
NPI assigned
Sep 30, 2011
Last updated
Aug 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X D68612 MD Primary

Addresses

Primary practice location

826 Washington Rd
Suite 215
Westminster, MD 21157-5750

Mailing address

826 Washington Rd
Suite 215
Westminster, MD 21157-5750
Phone (410) 876-9111

Other names 1

  • Advanced Cardiology of Carroll County 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 Phyinc148 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 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1609150242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 WASHINGTON RD",
            "address_2": "SUITE 215",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575750",
            "telephone_number": "410-876-9111",
            "fax_number": "410-857-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 WASHINGTON RD",
            "address_2": "SUITE 215",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575750",
            "telephone_number": "410-876-9111",
            "fax_number": "410-857-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-30",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "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": "443-422-9941",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": "D68612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Cardiology of Carroll County",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Cardiology of Carroll County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westminster, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.