NPIMap

Organization Active NPI

Lifebridge Community Physicians Inc

  • Gastroenterology Physician
  • Owings Mills, MD
National Provider Identifier
1609676766
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
LIFEBRIDGE COMMUNITY PHYSICIANS INC
Practice address
23 Crossroads Dr Ste 100
Owings Mills, MD 21117-5476
Phone
(410) 730-1000
Fax
(410) 730-2266
NPI assigned
Mar 18, 2025
Last updated
Mar 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 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
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

23 Crossroads Dr Ste 100
Owings Mills, MD 21117-5476

Mailing address

23 Crossroads Dr Ste 100
Owings Mills, MD 21117-5476
Phone (410) 730-1000

Other names 1

  • LifeBridge Suburban Physicians Group LLC D/B/A Dr. Russell Schub at Crossroads Other name

National Provider Directory

National Provider Directory
Tax ID family
Lifebridge Community Physicians148 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

NPI Registry JSON

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742256000000",
    "number": "1609676766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 CROSSROADS DR STE 100",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175476",
            "telephone_number": "410-730-1000",
            "fax_number": "410-730-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CROSSROADS DR STE 100",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175476",
            "telephone_number": "410-730-1000",
            "fax_number": "410-730-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "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": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeBridge Suburban Physicians Group LLC D/B/A Dr. Russell Schub at Crossroads",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.