LIFEBRIDGE COMMUNITY PHYSICIANS, INC (NPI# 1831457563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831457563 |
| Entity Type | Organization |
| Organization Name | LIFEBRIDGE COMMUNITY PHYSICIANS, INC |
| Other Organization Name | DRS GOUEL, BLOTNY AND SULLIVAN |
| Practice Address |
1205 York Rd Suite 18 Lutherville MD 21093-6210 |
| Practice Telephone | 4105836800 |
| Practice Fax Number | 4105835259 |
| Mailing Telephone | 4105836800 |
| Mailing Fax Number | 4105835259 |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2016-06-25 |
| Authorized Official Name | MR. BRIAN WHITE (VICE PRESIDENT) |
| Authorized Official Telephone | 4105212200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | MD | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Drs Gouel, Blotny and Sullivan | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285113704 | Lifebridge Community Physicians, Inc | Internal Medicine | 940 Madison Avenue First Floor, Baltimore, MD 27201 | 2018-08-07 |
| 1144565110 | Lifebridge Community Physicians, Inc | Internal Medicine | 12221 Tullamore Rd, Suite 3, Lutherville Timonium, MD 21093-7816 | 2012-12-03 |
| 1053662858 | Lifebridge Community Physicians, Inc | Internal Medicine | 12221 Tullamore Rd # 3, Lutherville Timonium, MD 21093-7816 | 2012-09-20 |
| 1851873970 | Lifebridge Community Physicians, Inc | Internal Medicine | 711 W. 40th Street, Suite 212a, Baltimore, MD 21211 | 2018-09-05 |
| 1093205841 | Lifebridge Community Physicians, Inc | Orthopaedic Surgery | 10084 Reisterstown Rd, Suite 300a, Owings Mills, MD 21117 | 2018-05-17 |
| 1255702338 | Lifebridge Community Physicians, Inc | Family Medicine | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2015-10-14 |
| 1437528551 | Lifebridge Community Physicians, Inc | Family Medicine | 6355 Ten Oaks Rd, Suite 202, Clarksville, MD 21029-1185 | 2015-09-18 |
| 1811365828 | Lifebridge Community Physicians, Inc | Orthopaedic Surgery | 2401 W Belvedere Ave, Suite 102-104, Baltimore, MD 21215-5216 | 2015-09-08 |
| 1851768493 | Lifebridge Community Physicians, Inc | Internal Medicine | 12221 Tullamore Rd, Lutherville Timonium, MD 21093-7816 | 2015-08-31 |
| 1760864870 | Lifebridge Community Physicians, Inc | Internal Medicine | 8114 Sandpiper Cir, Suite 206, Nottingham, MD 21236-4934 | 2015-06-25 |
| Street Address |
1205 YORK RD SUITE 18 |
| City | LUTHERVILLE |
| State | MD |
| Zip Code | 21093-6210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104820828 | Mark Frederic Williams | Otolaryngology | 1205 York Rd, Ste 33, Lutherville, MD 21093-6211 | 2005-06-09 |
| 1679922785 | Rujuta P Shah | Physical Therapist | 1205 York Rd, Suite 19, Lutherville, MD 21093-6210 | 2016-06-09 |
| 1437506334 | Deepti Pradhan | Psychologist | 1205 York Rd, Suite 11, Lutherville, MD 21093-6210 | 2016-05-20 |
| 1609258722 | Jun Park D.d.s.,p.a. | Dentist | 1205 York Rd, Suite 25a, Lutherville, MD 21093-6210 | 2015-06-25 |
| 1912301722 | Amy Waldron | Counselor | 1205 York Rd, 300 C, Lutherville, MD 21093-6210 | 2014-10-22 |
| 1437558947 | Debra Ann Snow-trueschler | Counselor | 1205 York Rd, Suite 39b, Lutherville, MD 21093-6210 | 2014-08-20 |
| 1619220472 | Hae Young Hong | Dentist | 1205 York Rd, Lutherville, MD 21093-6210 | 2012-10-17 |
| 1770847592 | Judith Berg | Social Worker | 1205 York Rd, Lutherville, MD 21093-6210 | 2012-06-26 |
| 1528350790 | Neurology Institute | Specialist | 1205 York Rd, Suite 18, Lutherville, MD 21093-6210 | 2011-05-06 |
| 1811296874 | Neurology Institute for Brain Health and Fitness, LLC | Psychiatry & Neurology | 1205 York Rd, Ste 18, Lutherville, MD 21093-6210 | 2011-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497309959 | Megan Lagergren | Social Worker | 1407 York Rd. Suite 307, Baltimore, MD 21093 | 2019-08-01 |
| 1437629003 | Mary Ann Lopus | Counselor | Villa Maria School 2300 Dulaney Valley Road, Timonium, MD 21093 | 2018-11-27 |
| 1275001455 | Hannah Michele Breckenridge | Social Worker | 1212 York Rd Ste A302, Lutherville, MD 21093 | 2018-11-06 |
| 1386111573 | Christina Calabrese | Social Worker | Villa Maria School, 2300 Dulaney Valley Road, Timonium, MD 21093 | 2018-10-26 |
| 1790279735 | Synopsis Healthscience | Internal Medicine | 19 Huntress Ct, Timonium, MD 21093 | 2018-06-21 |
| 1134648629 | Centers for Advanced Orthopaedics, LLC | Occupational Therapist | 1312 Bellona Ave Ste 302, Lutherville, MD 21093 | 2017-09-15 |
| 1134647746 | Andrea Stokes Rackowski | Social Worker | 1400 Front Ave. Suite 305, Lutherville, MD 21093 | 2017-09-03 |
| 1790200780 | Judson Franklin Force Jr. | Pediatrics | 309 Overlook Dr, Timonium, MD 21093 | 2017-08-10 |
| 1942722053 | Eundae Suk | Chiropractor | 1407 York Rd Ste 302, Lutherville, MD 21093 | 2017-07-10 |
| 1508301482 | Bh Brightview Mays Chapel Ridge Opco, LLC | Alzheimer Center (Dementia Center) | 12261 Roundwood Road, Timonium, MD 21093 | 2016-12-30 |
| Find all providers in zip 21093 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659368298 | Jason Neil Goldstein | Pediatrics | 10755 Falls Road, Suite 260, Lutherville, MD 21093-4515 | 2005-09-29 |
| 1851835136 | Lifebridge Suburban Physician Group II, LLC | Pediatrics | 12221 Tullamore Rd, Lutherville, MD 21093-7816 | 2016-12-06 |
| 1033455522 | Elizabeth A Donahoo | Pediatrics | 10807 Falls Rd, Suite 200, Lutherville, MD 21093-4591 | 2013-01-02 |
| 1477878585 | Jason Paul Cervenka | Pediatrics | 10807 Falls Rd, Suite 200, Lutherville, MD 21093-4591 | 2010-03-31 |
| 1972828077 | Julie Frances King | Pediatrics | 10755 Falls Rd, Suite 260, Lutherville, MD 21093-4515 | 2010-03-31 |
| 1265766653 | Julia Minjung Kim | Pediatrics | 1447 York Rd, Suite 100, Lutherville, MD 21093-6017 | 2009-10-01 |
| 1396917506 | Jacqueline G Isola | Pediatrics | 10807 Falls Rd, Suite 200, Lutherville, MD 21093-4591 | 2008-03-27 |
| 1801068002 | Theresa J Gagen-hursey | Pediatrics | 10807 Falls Rd, Suite 200, Lutherville, MD 21093-4591 | 2008-03-27 |
| 1588846562 | Nicole Jean Gable | Pediatrics | 10755 Falls Road, Suite 260, Lutherville, MD 21093-4515 | 2007-11-30 |
| 1063603447 | Drs Gouel and Blotny | Pediatrics | 1205 York Road, Suite 18, Lutherville, MD 21093 | 2007-08-09 |
| Find all providers in LUTHERVILLE | ||||
| City | LUTHERVILLE |
| Zip Code | 21093 |
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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.