LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC


Address: 1167 Merritt Blvd, Store #1167 C-2, Dundalk, MD 21222-1438
Phone: 4102822104

LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC (NPI# 1932592151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932592151
Entity Type Organization
Organization Name LIFEBRIDGE SPORTS MEDICINE AND REHABILITATION LLC
Other Organization Name PHYSIOTHERAPY ASSOCIATES
Practice Address 1167 Merritt Blvd
Store #1167 C-2
Dundalk
MD 21222-1438
Mailing Address 4714 Gettysburg Rd
Legal Dept
Mechanicsburg
PA 17055-4325
Practice Telephone 4102822104
Practice Fax Number 4102823950
Mailing Telephone 7179721100
Enumeration Date 2015-03-12
Last Update Date 2018-10-26
Authorized Official Name MR. MICHAEL E TARVIN (VICE PRESIDENT & SECRETARY)
Authorized Official Telephone 7179721100
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0400X Clinic/Center
Specialization: Rehabilitation
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Physiotherapy Associates Doing Business As Name - Organization

Other Provider IDs and Locations

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
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
1033755434 Lifebridge Sports Medicine and Rehabilitation LLC Clinic/Center 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 2019-11-20
1326699919 Lifebridge Sports Medicine and Rehabilitation LLC Clinic/Center 1011 Baltimore Blvd, Westminster, MD 21157-7055 2019-09-25

Office Location

Street Address 1167 MERRITT BLVD
STORE #1167 C-2
City DUNDALK
State MD
Zip Code 21222-1438

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1922634534 Progressive Multi Medical Services Inc Nurse Practitioner 7704 Trappe Road, Dundalk, MD 21222 2020-03-14
1881240802 Waleed Mazhar Khan Pharmacist 29-31 Sipping Pl, Baltimore, MD 21222 2019-08-15
1043773724 Agnes Kavari Occupational Therapy Assistant 7232 German Hill Road, Heritage Center, Baltimore, MD 21222 2019-04-10
1609335702 Addiction Treatment of Maryland Substance Abuse Rehabilitation Facility 19 Center Place, 1st Floor, Baltimore, MD 21222 2019-03-18
1558833368 Millennium Residential Inc. Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 1709 Holaview Road, Dundalk, MD 21222 2018-12-19
1639691447 Tenicia S Washington Nurse Practitioner 1709 Holaview Rd, Dundalk, MD 21222 2017-07-13
1548708126 Kevin Anthony Mason Counselor 7827 Wise Avenue, Dundalk Counseling Center, Baltimore, MD 21222 2017-02-03
1023569266 Rachel Renee Barbarino Physician Assistant 1934 Ewald Ave, Baltimore, MD 21222 2016-10-24
1023562576 Bd Health Services, Inc Counselor 3955 North Point Rd., Dundalk, MD 21222 2016-08-12
1205287596 Dundalk Health Services, Inc. Counselor 6706 Holabird Ave, Baltimore, MD 21222 2016-06-28
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Taxonomy Information

Taxonomy Code 261QR0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

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
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Competitor

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City DUNDALK
Zip Code 21222

Improve Information

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Dataset Information

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.

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