LIFEBRIDGE SPORTS MEDICINE & REHABILITATION LLC (NPI# 1114215399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114215399 |
| Entity Type | Organization |
| Organization Name | LIFEBRIDGE SPORTS MEDICINE & REHABILITATION LLC |
| Other Organization Name | LIFEBRIDGE HEALTH PHYSICAL THERAPY |
| Practice Address |
1364 Martin Blvd Ste 5 Middle River MD 21220-4104 |
| Mailing Address |
4714 Gettysburg Rd Legal Dept Mechanicsburg PA 17055-4325 |
| Practice Telephone | 4106863600 |
| Practice Fax Number | 4106861056 |
| Mailing Telephone | 7179721100 |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2019-07-16 |
| Authorized Official Name | MR. MICHAEL E TARVIN (VICE PRESIDENT & SECRETARY) |
| 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 |
| Other Name | Type Code |
|---|---|
| Lifebridge Health Physical Therapy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1003104282 | Lifebridge Sports Medicine & Rehabilitation LLC | Clinic/Center | 111 Bata Blvd, Suite C, Belcamp, MD 21017-1427 | 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 |
1364 MARTIN BLVD STE 5 |
| City | MIDDLE RIVER |
| State | MD |
| Zip Code | 21220-4104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487289245 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 1364 Martin Blvd Ste 5, Middle River, MD 21220-4104 | 2020-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881164119 | Sian Crosby | Speech-Language Pathologist | Glenmar Elementrary School, 9700 Community Drive, Middle River, MD 21220 | 2018-11-29 |
| 1336545029 | Andrea Tuck | Counselor | 24 Granny Smith Ct, Baltimore, MD 21220 | 2014-11-07 |
| 1356762959 | Johns Hopkins Hospital | General Acute Care Hospital | 11550 Crossroad Circle, Unit 606, Middle River, MD 21220 | 2013-12-27 |
| 1770693392 | Costco Wholesale Corporation | Pharmacy | 9919 Pulaski Hwy, Baltimore, MD 21220 | 2006-08-30 |
| 1255393344 | James Wallace Carpenter | Physician Assistant | 10 North Green St, Va Med Center Ward 6b, Baltimore, MD 21220 | 2006-04-04 |
| 1386624427 | Allen F Clowers | Family Medicine | 107 Beacon Road, Baltimore, MD 21220 | 2006-01-17 |
| 1306229794 | Dorcas Lwanga | Dietitian, Registered | 201 Ballard Ave, Middle River, MD 21220 | 2015-07-02 |
| 1437550761 | Eastern Avenue Dental, LLC | Dentist | 12412 Eastern Ave, Baltimore, MD 21220 | 2014-09-05 |
| 1366857617 | Suprina Kaur | Dentist | 12412 Eastern Ave, Middle River, MD 21220 | 2014-06-25 |
| 1316905227 | Chienyenwa E. Nwachinemere | Internal Medicine | 201 Ballard Ave, Middle River, MD 21220 | 2006-05-02 |
| Find all providers in zip 21220 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487289245 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 1364 Martin Blvd Ste 5, Middle River, MD 21220-4104 | 2020-03-11 |
| 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 | MIDDLE RIVER |
| Zip Code | 21220 |
Please comment or provide details below to improve the information on LIFEBRIDGE SPORTS MEDICINE & 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.