NPIMap

Organization Active NPI

Lifebridge Community Physicians Inc

  • Family Medicine Physician
  • Hunt Valley, MD
National Provider Identifier
1619777315
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIFEBRIDGE COMMUNITY PHYSICIANS INC
Practice address
118 Shawan Rd Ste 220
Hunt Valley, MD 21030-1318
Phone
(410) 469-4950
Fax
(410) 601-6698
NPI assigned
Mar 13, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 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
(434) 229-9414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

118 Shawan Rd Ste 220
Hunt Valley, MD 21030-1318

Mailing address

118 Shawan Rd Ste 220
Hunt Valley, MD 21030-1318
Phone (410) 469-4950

Other names 1

  • LifeBridge Potomac Professionals at Hunt Valley Other name

National Provider Directory

National Provider Directory
Tax ID family
DRS Gouel and Blotny148 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": "1741824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741824000000",
    "number": "1619777315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 SHAWAN RD STE 220",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210301318",
            "telephone_number": "410-469-4950",
            "fax_number": "410-601-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 SHAWAN RD STE 220",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210301318",
            "telephone_number": "410-469-4950",
            "fax_number": "410-601-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-13",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "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": "434-229-9414"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeBridge Potomac Professionals at Hunt Valley",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hunt Valley, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.