LIFEBRIDGE SPORTS MEDICINE & REHABILITATION LLC (NPI# 1003104282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003104282 |
| Entity Type | Organization |
| Organization Name | LIFEBRIDGE SPORTS MEDICINE & REHABILITATION LLC |
| Practice Address |
111 Bata Blvd Suite C Belcamp MD 21017-1427 |
| Mailing Address |
Po Box 1245 Indiana PA 15701-5245 |
| Practice Telephone | 4102736000 |
| Practice Fax Number | 4102736061 |
| Mailing Telephone | 7244653496 |
| Mailing Fax Number | 2154134682 |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2012-04-25 |
| Authorized Official Name | JAYNE FLECK POOL (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Telephone | 6108844803 |
| 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 |
|---|---|---|---|---|
| 1114215399 | Lifebridge Sports Medicine & Rehabilitation LLC | Clinic/Center | 1364 Martin Blvd Ste 5, Middle River, MD 21220-4104 | 2011-07-21 |
| 1770689879 | Lifebridge Sports Medicine & Rehabilitation LLC | Clinic/Center | 12201 Tullamore Rd, Timonium, MD 21093-7816 | 2006-09-15 |
| 1972852929 | Lifebridge Sports Medicine & Rehabilitation LLC | Clinic/Center | 10 Crossroads Drive, Suite 208-216, Owings Mills, MD 21117-5461 | 2012-09-06 |
| 1902184013 | Lifebridge Sports Medicine & Rehabilitation LLC | Clinic/Center | 2120 Blue Spruce Dr E, Suite D, Bel Air, MD 21015-6802 | 2011-07-25 |
| 1467730572 | Lifebridge Sports Medicine & Rehabilitation LLC | Clinic/Center | 118 Shawan Rd, Hunt Valley, MD 21030-1318 | 2011-07-25 |
| 1922396100 | Lifebridge Sports Medicine & Rehabilitation LLC | Clinic/Center | 9712 Belair Rd, Suite 101, Nottingham, MD 21236-1111 | 2011-07-21 |
| 1134291156 | Lifebridge Sports Medicine & Rehabilitation LLC | Clinic/Center | 1836 Greene Tree Rd, Baltimore, MD 21208-1301 | 2006-11-14 |
| 1740386903 | Lifebridge Sports Medicine & Rehabilitation LLC | Clinic/Center | 3506 Gwynnbrook Ave, Suite 148, Owings Mills, MD 21117-1409 | 2006-09-15 |
| Street Address |
111 BATA BLVD SUITE C |
| City | BELCAMP |
| State | MD |
| Zip Code | 21017-1427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558373951 | Henning & Cole Therapy Associates, Ltd. | Occupational Therapist | 111 Bata Blvd, Suite C, Belcamp, MD 21017-1431 | 2006-08-13 |
| 1881070456 | Michael Webb Jr. | Dentist | 111 Bata Blvd, Suite D, Belcamp, MD 21017-1427 | 2015-08-06 |
| 1417225723 | Christine Yurcik-dominick | Physical Therapist | 111 Bata Blvd, Belcamp, MD 21017-1427 | 2011-12-01 |
| 1215190921 | Michael Kirchner | Dentist | 111 Bata Blvd, Belcamp, MD 21017-1427 | 2008-07-03 |
| 1386779643 | Neelu S Milak | Dentist | 111 Bata Blvd, Suite D, Belcamp, MD 21017-1431 | 2007-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932187390 | Lise M Greenberg | Family Medicine | 103 Bata Blvd Ste A, Belcamp, MD 21017 | 2006-01-05 |
| 1013912039 | Gloria Fern Moretz | Nurse Practitioner | 103 Bata Blvd, John Hopkins Community Physicians Waters Edge, Baltimore, MD 21017 | 2005-06-16 |
| 1689937260 | Glass Health Programs, Inc. | Community/Behavioral Health | 1361 Brass Mill Rd, Suite A, Bel Camp, MD 21017 | 2012-06-19 |
| 1861537532 | Laurie Bothwell | Emergency Medicine | 103 Bata Blvd, Suite A, Belcamp, MD 21017 | 2007-02-21 |
| 1730237330 | Stephen E Gentile | Dentist | 1321 Riverside Pkwy, D 4, Belcamp, MD 21017 | 2007-01-08 |
| 1932204716 | Elizabeth Jo Johnson | Physician Assistant | 103 Bata Blvd Ste A, Belcamp, MD 21017 | 2006-09-14 |
| 1215031612 | Marilyn Moshay Cooper | Pediatrics | 103 Bata Blvd Ste A, Belcamp, MD 21017 | 2006-09-08 |
| 1619070125 | Bernhard Birnbaum | Internal Medicine | 103 Bata Blvd Ste A, Belcamp, MD 21017 | 2006-09-07 |
| 1689184442 | Arrow Child & Family Ministries of Maryland | Community/Behavioral Health | 1370 Brass Mill Rd, Belcamp, MD 21017-1211 | 2017-10-06 |
| 1346887486 | Lori Ann Levy | Occupational Therapist | 1370 Brass Mill Rd, Belcamp, MD 21017-1211 | 2019-12-09 |
| Find all providers in zip 21017 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| 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 | ||||
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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.