LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC (NPI# 1033755434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033755434 |
Entity Type | Organization |
Organization Name | LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC |
Practice Address |
6190 Georgetown Blvd Eldersburg MD 21784-6460 |
Mailing Address |
4714 Gettysburg Rd Mechanicsburg PA 17055-4325 |
Practice Telephone | 4105524235 |
Practice Fax Number | 4105524248 |
Mailing Telephone | 7179754556 |
Enumeration Date | 2019-11-20 |
Last Update Date | 2019-11-20 |
Authorized Official Name | MICHAEL E TARVIN (VICE PRESIDENT) |
Authorized Official Telephone | 7179721100 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154931962 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 41 Magna Way Ste 140, Westminster, MD 21157-3073 | 2020-08-06 |
1770059701 | Lifebridge Sports Medicine and Rehabilitation LLC | Occupational Therapist | 19 Walker Ave Ste 100, Pikesville, MD 21208-4006 | 2018-10-17 |
1992271902 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 8114 Sandpiper Cir Ste 114, Baltimore, MD 21236-5901 | 2018-10-17 |
1215421532 | Lifebridge Sports Medicine and Rehabilitation LLC | Durable Medical Equipment & Medical Supplies | 1393 Progress Way Ste 907, Eldersburg, MD 21784-6473 | 2018-06-20 |
1932592151 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 1167 Merritt Blvd, Store #1167 C-2, Dundalk, MD 21222-1438 | 2015-03-12 |
1255941522 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2020-08-03 |
1578198339 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 1836 Greene Tree Rd, Baltimore, MD 21208-1381 | 2020-03-11 |
1487289245 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 1364 Martin Blvd Ste 5, Middle River, MD 21220-4104 | 2020-03-11 |
1487289781 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 8114 Sandpiper Cir Ste 114, Baltimore, MD 21236-5901 | 2020-03-06 |
1326699919 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 1011 Baltimore Blvd, Westminster, MD 21157-7055 | 2019-09-25 |
Street Address |
6190 GEORGETOWN BLVD |
City | ELDERSBURG |
State | MD |
Zip Code | 21784-6460 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427042027 | Jill Marie Koeppen | Nurse Practitioner | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2005-09-09 |
1255941522 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2020-08-03 |
1245892819 | Kristen Allard | Registered Nurse | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2019-07-03 |
1265908446 | Crystal Olivia Leonard | Nurse Practitioner | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2018-10-16 |
1578055497 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2018-06-06 |
1841732047 | Melissa Bassett | Nurse Practitioner | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2016-11-06 |
1891247003 | Lifebridge Community Physicians, Inc. | Internal Medicine | 6190 Georgetown Blvd, Suite 104, Eldersburg, MD 21784-6460 | 2016-11-04 |
1730539289 | Jay Steven Orr | Family Medicine | 6190 Georgetown Blvd, Eldersburg, MD 21784 | 2016-06-15 |
1649662776 | Genna Sellers | Nurse Practitioner | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2015-02-26 |
1386049260 | Fatemeh Jafari Farshami | Student in an Organized Health Care Education/Training Program | 6190 Georgetown Blvd, Suite 110, Eldersburg, MD 21784 | 2014-11-04 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033681085 | Kathleen Busching | Occupational Therapy Assistant | Intergrace Fairhaven, 7200 Third Ave, Sykesville, MD 21784 | 2018-12-31 |
1619450376 | Mackenzie Fleming | Counselor | 6220 Georgetown Blvd Suite C, Eldersburg, MD 21784 | 2018-09-10 |
1316426919 | Rebecca Rubin | Nurse Practitioner | 1380 Progress Way, Suite 102, Eldersburg, MD 21784 | 2018-08-14 |
1417473273 | Andrey Doroshenko | Dentist | 1722 Underwood Road, Sykesville, MD 21784 | 2017-08-14 |
1992229694 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 6400 Georgetown Blvd, Eldersburg, MD 21784 | 2017-08-03 |
1457894495 | Bethany Six | Nurse Practitioner | 6190 Gerogetown Blvd, Eldersburg, MD 21784 | 2016-11-23 |
1982011821 | Fast Track Urgent Care, LLC | Clinic/Center | 1315 Breton Drive, Eldersburg, MD 21784 | 2014-07-11 |
1588097984 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 5961 Exchange Dr, Suite 100, Eldersburg, MD 21784 | 2013-08-21 |
1356690986 | Kayla Nicole Koster | Speech-Language Pathologist | 1702 Liberty Road, First Floor, Sykesville, MD 21784 | 2012-08-29 |
1558645663 | Fusion Dental | Dentist | 5959 Exchange Drive, Suite 116, Eldersburg, MD 21784 | 2011-10-07 |
Find all providers in zip 21784 |
Taxonomy Code | 261QR0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659655413 | Senior Smart, LLC | Clinic/Center | 1430 Progress Way Ste 105, Eldersburg, MD 21784-6461 | 2011-09-28 |
1255941522 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2020-08-03 |
1578055497 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2018-06-06 |
1265538359 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2006-09-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851999551 | Physiotherapy Assoicates, Inc. | Clinic/Center | 11200 Rockville Pike Ste 240, Rockville, MD 20852-3154 | 2020-10-14 |
1790398618 | Holistic Health- Counseling & Coaching LLC | Clinic/Center | 2453 Maryland Ave Fl 1, Baltimore, MD 21218-5018 | 2020-08-29 |
1427669159 | Phaze Counseling Services Inc | Clinic/Center | 4425 Fitch Ave Ste 118, Nottingham, MD 21236-3927 | 2020-08-14 |
1154931962 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 41 Magna Way Ste 140, Westminster, MD 21157-3073 | 2020-08-06 |
1821606583 | Fine, Bryant & Wah, Inc. | Clinic/Center | 1707 Whetstone Way, Baltimore, MD 21230-5198 | 2020-07-20 |
1912520685 | Recovery Center of Maryland | Clinic/Center | 211 E 25th St, Baltimore, MD 21218-5217 | 2020-05-28 |
1013546944 | National Rehabiliation Hospital, Inc | Clinic/Center | 1838 Greene Tree Rd Ste 245, Baltimore, MD 21208-7110 | 2020-04-02 |
1831734920 | On Track Rehabilitation, LLC | Clinic/Center | 3702 Brenbrook Dr, Randallstown, MD 21133-4116 | 2019-11-12 |
1184277303 | Select Physical Therapy Holdings, Inc. | Clinic/Center | 1305 S Salisbury Blvd Unit 5, Salisbury, MD 21801-6845 | 2019-07-17 |
1235791625 | Focused Care, LLC | Clinic/Center | 8070 Georgia Ave Ste 605, Silver Spring, MD 20910-4948 | 2019-07-05 |
Find all providers with the same taxonomy |
City | ELDERSBURG |
Zip Code | 21784 |
Please comment or provide details below to improve the information on LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.