NPIMap

Organization Active NPI

Lifebridge Primary Care of North Carroll, LLC

Doing business as Carroll Medical Group

  • Family Medicine Physician
  • Hampstead, MD
National Provider Identifier
1811398175
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIFEBRIDGE PRIMARY CARE OF NORTH CARROLL, LLC
Doing business as
Carroll Medical Group
Practice address
4231 N Woods TRL Ste 100
Hampstead, MD 21074-3204
Phone
(410) 374-9391
Fax
(410) 374-1866
NPI assigned
Sep 5, 2014
Last updated
Nov 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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
(443) 422-9941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD Primary

Addresses

Primary practice location

4231 N Woods TRL Ste 100
Hampstead, MD 21074-3204

Mailing address

4231 N Woods TRL Ste 100
Hampstead, MD 21074-3204
Phone (410) 374-9391

Other names 1

  • Carroll Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150319001691 MD Part B Supplier - Clinic/Group Practice 2769709393 Receives reassigned benefits from 13 practitioners
Practice locations: Hampstead, MD

National Provider Directory

National Provider Directory

Member of 1

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

Locations

10084 Reisterstown Rd
Ste 200A
Owings Mills, MD 21117
Phone (410) 552-5050

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1811398175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4231 N WOODS TRL STE 100",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210743204",
            "telephone_number": "410-374-9391",
            "fax_number": "410-374-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4231 N WOODS TRL STE 100",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210743204",
            "telephone_number": "410-374-9391",
            "fax_number": "410-374-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE PRIMARY CARE OF NORTH CARROLL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-05",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "WRIGHT-SISK",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-422-9941"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carroll Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carroll Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hampstead, MD

Sources for this page

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