NPIMap

Organization Active NPI

Lifebridge Orthopedic Specialists, LLC

  • Neurological Surgery Physician
  • Edgewood, MD
National Provider Identifier
1891679502
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
LIFEBRIDGE ORTHOPEDIC SPECIALISTS, LLC
Practice address
1401 Pulaski Hwy Ste M
Edgewood, MD 21040-1398
Phone
(410) 601-4417
Fax
(410) 601-7138
NPI assigned
Aug 5, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

1401 Pulaski Hwy Ste M
Edgewood, MD 21040-1398

Mailing address

1401 Pulaski Hwy Ste M
Edgewood, MD 21040-1398
Phone (410) 601-4417

Other names 1

  • LifeBridge Neurosciences at Pulaski Other name

National Provider Directory

National Provider Directory
Tax ID family
Lifebridge Neurosciences at Old Court15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1754352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1891679502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 PULASKI HWY STE M",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210401398",
            "telephone_number": "410-601-4417",
            "fax_number": "410-601-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 PULASKI HWY STE M",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210401398",
            "telephone_number": "410-601-4417",
            "fax_number": "410-601-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRIDGE ORTHOPEDIC SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "WRIGHT-SISK",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "REBECCA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-422-9941"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeBridge Neurosciences at Pulaski",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Edgewood, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.