LIFEBRIDGE COMMUNITY PHYSICIANS (NPI# 1407256985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407256985 |
| Entity Type | Organization |
| Organization Name | LIFEBRIDGE COMMUNITY PHYSICIANS |
| Other Organization Name | LIFEBRIDGE CRITICAL CARE |
| Practice Address |
5401 Old Court Rd Randallstown MD 21133-5103 |
| Practice Telephone | 4105215973 |
| Practice Fax Number | 4105217669 |
| Mailing Telephone | 4105215973 |
| Mailing Fax Number | 4105217669 |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2014-09-03 |
| Authorized Official Name | MARY WRIGHT-SISK (DIRECTOR) |
| Authorized Official Telephone | 4105212200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
MD | Allopathic & Osteopathic Physicians | |
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
MD | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| LifeBridge Critical Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225653272 | Lifebridge Community Physicians | Orthopaedic Surgery | 1011 Baltimore Blvd, Westminster, MD 21157-7055 | 2020-06-15 |
| 1962756189 | Lifebridge Community Physicians | Pediatrics | 2003 Rock Spring Rd, Forest Hill, MD 21050-2611 | 2012-11-09 |
| Street Address |
5401 OLD COURT RD |
| City | RANDALLSTOWN |
| State | MD |
| Zip Code | 21133-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427054089 | Michael Holloway | Specialist | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2005-06-28 |
| 1235746231 | Brianne Elizabeth Leaf | Surgery | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-09-24 |
| 1528674132 | April Puskar | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-09-18 |
| 1790398659 | Jessica Stehman | Physician Assistant | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-08-28 |
| 1578176863 | Margot Wallace | Physician Assistant | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-08-26 |
| 1740805779 | Elizabeth M Atkinson | Physician Assistant | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-06-16 |
| 1316571722 | Morgan Ariel Murray | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-02-24 |
| 1811527278 | Ifeoma Jennifer Dunn | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-01-23 |
| 1598395725 | Ayodeji Bamidele Olawale | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-01-15 |
| 1336779578 | Lerin Jackson | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-01-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649898313 | Olivia David | Registered Nurse | 3525 Liberty Resource Drive, Randallstown, MD 21133 | 2020-07-09 |
| 1366082547 | Jerry Njomgert Christopher | Home Health Aide | 9106 Sandra Ct. Randallstown, Randallstown, MD 21133 | 2020-01-15 |
| 1487138913 | For Hope's Sake, LLC | Substance Abuse Rehabilitation Facility | 9905 Southhall Road, Randallstown, MD 21133 | 2018-09-20 |
| 1295214393 | Levindale Hebrew Geriatric Center & Hospital Inc | Clinic/Center | Lifebridge Health Adult Day Services, 5400 Old Court Road, Randallstown, MD 21133 | 2018-08-09 |
| 1235623968 | Away of Change Counseling Service, LLC | Counselor | 5310 Old Court Rd Ste 304, Randallstown, MD 21133 | 2018-06-16 |
| 1922503382 | Top Care Residential Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8607 Liberty Rd, Randallstown, MD 21133 | 2018-03-28 |
| 1497274880 | Yushika M Shepherd | In Home Supportive Care | 8911 Allenswood Rd, Randallstown, MD 21133 | 2017-09-17 |
| 1790208718 | Productive Lives Mental Health, LLC | Clinic/Center | Randallstown Medical Center 5310 Old Court Rd Suite 308, Randallstown, MD 21133 | 2017-07-21 |
| 1982136198 | Marla Rosanne Yee | Dentist | 5415 Old Court Road, Suite 01, Randallstown, MD 21133 | 2017-03-28 |
| 1598203549 | Traci Harris | Social Worker | 9633 Liberty Rd. (suites H&j), Randallstown, MD 21133 | 2017-02-09 |
| Find all providers in zip 21133 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417272964 | Kelli M Eimer | Internal Medicine | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2010-03-28 |
| 1760423438 | Steven D Fuller | Internal Medicine | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2006-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831694066 | Rajesh M Shah M D | Internal Medicine | 8353 Governor Run, Ellicott City, MD 21043-3448 | 2018-03-29 |
| 1376994129 | Integra Clinical Services, LLC | Internal Medicine | 9055 Tamar Dr, Columbia, MD 21045-2756 | 2016-06-23 |
| 1871949917 | Penelope Scott, Md | Internal Medicine | 11824 Falls Rd, Cockeysville, MD 21030-1605 | 2016-05-08 |
| 1598121337 | Dennis Frank | Internal Medicine | 6 Southgate Ave, Annapolis, MD 21401-2710 | 2016-01-09 |
| 1861812182 | Samuel Raouf | Internal Medicine | 5051 Greenspring Ave Ste 302, Baltimore, MD 21209-4358 | 2014-04-25 |
| 1265852263 | James Shelhamer | Internal Medicine | Room 2c145 Bldg 10, Nih, Bethesda, MD 20892-0001 | 2014-04-17 |
| 1922341338 | Aparna Balasubramanian | Internal Medicine | 1830 E Monument St Fl 5, Department of Pulmonary and Critical Care Medicine, Baltimore, MD 21287-0020 | 2013-04-03 |
| 1245578426 | Mary Joy Drass | Internal Medicine | 5565 Sterrett Pl Fl 5, Columbia, MD 21044-2665 | 2013-01-23 |
| 1699027151 | Jack E Zimmerman | Internal Medicine | 17612 Coatbridge Pl, Olney, MD 20832-2318 | 2012-10-09 |
| 1053675074 | William Brian Karkowsky | Internal Medicine | 6503 Sanzo Rd Apt F, Baltimore, MD 21209-2412 | 2012-06-25 |
| Find all providers with the same taxonomy | ||||
| City | RANDALLSTOWN |
| Zip Code | 21133 |
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| 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.