NPIMap

Organization Active NPI

Lifebridge Sports Medicine and Rehabilitation LLC

Doing business as Novacare Rehabilitation

  • Physical Therapy Clinic/Center
  • Baltimore, MD
National Provider Identifier
1750966602
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC
Doing business as
Novacare Rehabilitation
Practice address
519 Bayview Blvd
Baltimore, MD 21224-2825
Phone
(443) 335-6910
Fax
(443) 335-6911
NPI assigned
Mar 12, 2021
Last updated
Oct 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Authorized official

Name
John F Duggan
Title
Vice President
Phone
(717) 972-1100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

519 Bayview Blvd
Baltimore, MD 21224-2825

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100

Other names 1

  • Novacare Rehabilitation Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180724000217 MD Part B Supplier - Clinic/Group Practice 4385787910 Receives reassigned benefits from 29 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Towson, MD; Baltimore, MD
O20181003002704 MD Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 4385787910 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Westminster, MD; Baltimore, MD; Eldersburg, MD; Hampstead, MD

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lifebridge Sports Medicine Rehabilitation LLC29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

5601 Eastern Ave
Unit 406
Baltimore, MD 21224

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760918400000",
    "number": "1750966602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 BAYVIEW BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242825",
            "telephone_number": "443-335-6910",
            "fax_number": "443-335-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-12",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A",
        "authorized_official_last_name": "DUGGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novacare Rehabilitation",
            "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 Oct 20, 2025; 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.