NPIMap

Organization Active NPI

Lifebridge Investments, Inc

Doing business as LifeBridge Community Practices, LLC d/b/a Clinical Associates ASC

  • Endoscopy Clinic/Center
  • Towson, MD
National Provider Identifier
1861689382
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
License
A Issued in MD
Legal business name
LIFEBRIDGE INVESTMENTS, INC
Doing business as
LifeBridge Community Practices, LLC d/b/a Clinical Associates ASC
Practice address
515 Fairmount Ave
Ste 100a
Towson, MD 21286-5466
Phone
(410) 494-1315
Fax
(410) 494-1361
NPI assigned
Sep 28, 2007
Reactivated
Apr 23, 2008
Organization subpart
Yes
Parent organization
LIFEBRIDGE INVESTMENTS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 14, 2012

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

Authorized official

Name
G Michael Foster
Title
Ceo
Phone
(410) 296-5300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endoscopy Clinic/Center 261QE0800X
Endoscopy Clinic/Center 261QE0800X A MD Primary

Addresses

Primary practice location

515 Fairmount Ave
Ste 100a
Towson, MD 21286-5466

Mailing address

515 Fairmount Ave
Credentialing Office
Towson, MD 21286
Phone (410) 494-1324

Other identifiers 1

IdentifierTypeStateIssuer
417384800MedicaidMD

Other names 1

  • LifeBridge Community Practices, LLC d/b/a Clinical Associates ASC Doing business as

National Provider Directory

National Provider Directory
Part of
Lifebridge Investments Inc

Locations

515 Fairmount Ave
Ofc
Towson, MD 21286
Phone (410) 494-1324

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344902400000",
    "number": "1861689382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 FAIRMOUNT AVE",
            "address_2": "CREDENTIALING OFFICE",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "21286",
            "telephone_number": "410-494-1324",
            "fax_number": "410-494-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 FAIRMOUNT AVE",
            "address_2": "STE 100A",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865466",
            "telephone_number": "410-494-1315",
            "fax_number": "410-494-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE INVESTMENTS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFEBRIDGE INVESTMENTS, INC",
        "enumeration_date": "2007-09-28",
        "last_updated": "2012-08-14",
        "deactivation_date": "2008-02-11",
        "reactivation_date": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "G",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-296-5300"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "MD",
            "license": "A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417384800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeBridge Community Practices, LLC d/b/a Clinical Associates ASC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; 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.