Lifebridge Multi-Specialty. LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LIFEBRIDGE MULTI-SPECIALTY. LLC

Doing business as

Clinical Associates

Practice address

515 Fairmount Ave
Towson, MD 21286-5466

Phone

(410) 296-5300

Fax

(410) 494-1302

NPI assigned

Nov 25, 2014

Last updated

Nov 25, 2014By the provider in NPPES

Organization subpart

No

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

(410) 521-2200

Specialties & licenses 9

Addresses

Other names 1

• Clinical Associates Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1699172387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 FAIRMOUNT AVE",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865466",
            "telephone_number": "410-296-5300",
            "fax_number": "410-494-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 FAIRMOUNT AVE",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865466",
            "telephone_number": "410-296-5300",
            "fax_number": "410-494-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE MULTI-SPECIALTY. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-25",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "WRIGHT-SISK",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-521-2200"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MD",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lifebridge Community Physicians, Inc
• Lifebridge Community Physicians, Inc (Main Street Pediatrics)
• Lifebridge Community Physicians, Inc. (Dr. Anisa Mirza)
• Lifebridge Investments, Inc (LifeBridge Community Practices, LLC d/b/a Clinical Associates ASC)
• Lifebridge Investments, Inc. and Subsidiaries (LifeBridge Community Practices, LLC Clinical Associates Sleep Center)
• Lifebridge Orthopedic Specialists, LLC
• Lifebridge Sports Medicine & Rehabilitation, LLC (Lifebridge Health Physical Therapy)
• Lifebridge Sports Medicine and Rehabilitation LLC (Lifebridge Health Physical Therapy)
• Lifebridge Sports Medicine and Rehabilitation LLC
• Lifebridge Suburban Physician Group II LLC

• Internal Medicine Physician in Towson, MD
• Providers in Towson, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.