Organization Active NPI

Lifebridge Community Physicians, Inc.

Doing business as BW Primary Care, LLC

  • Family Medicine Physician
  • Eldersburg, MD
National Provider Identifier
1891247003
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIFEBRIDGE COMMUNITY PHYSICIANS, INC.
Doing business as
BW Primary Care, LLC
Practice address
6190 Georgetown Blvd Ste 104
Eldersburg, MD 21784-6460
Phone
(410) 552-5050
Fax
(410) 552-0200
NPI assigned
Nov 4, 2016
Last updated
Mar 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
Mary R Wright-Sisk
Title
Director
Phone
(443) 422-9941

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

6190 Georgetown Blvd Ste 104
Eldersburg, MD 21784-6460

Mailing address

6190 Georgetown Blvd Ste 104
Eldersburg, MD 21784-6460
Phone (410) 552-5050

Other names 2

  • BW Primary Care, LLC Doing business as
  • BW Primary Care, LLC - Eldersburg Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110627000318 MD Part B Supplier - Clinic/Group Practice 3678751468 Receives reassigned benefits from 358 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

104 Plumtree Rd
Ste 115
Bel Air, MD 21015
Phone (410) 515-4300

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

6190 Georgetown Blvd
Ste 104
Sykesville, MD 21784
Phone (410) 356-0410

Practitioners & affiliated clinicians

Practitioners 8

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": "1478217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1891247003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6190 GEORGETOWN BLVD STE 104",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846460",
            "telephone_number": "410-552-5050",
            "fax_number": "410-552-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6190 GEORGETOWN BLVD STE 104",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846460",
            "telephone_number": "410-552-5050",
            "fax_number": "410-552-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE COMMUNITY PHYSICIANS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-04",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "WRIGHT-SISK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-422-9941"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BW Primary Care, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BW Primary Care, LLC - Eldersburg",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eldersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; 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.