LIFEBRIDGE INVESTMENTS, INC (NPI# 1861689382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861689382 |
Entity Type | Organization |
Organization Name | LIFEBRIDGE INVESTMENTS, INC |
Other Organization Name | LIFEBRIDGE COMMUNITY PRACTICES, LLC D/B/A CLINICAL ASSOCIATES ASC |
Practice Address |
515 Fairmount Ave Ste 100a Towson MD 21286-5466 |
Mailing Address |
515 Fairmount Ave Credentialing Office Towson MD 21286 |
Practice Telephone | 4104941315 |
Practice Fax Number | 4104941361 |
Mailing Telephone | 4104941324 |
Mailing Fax Number | 4104941361 |
Enumeration Date | 2007-09-28 |
Last Update Date | 2012-08-14 |
NPI Deactivation Date | 02/11/2008 |
NPI Reactivation Date | 2008-04-23 |
Authorized Official Name | G MICHAEL FOSTER (CEO) |
Authorized Official Telephone | 4102965300 |
Is Organization Subpart | Y |
Parent Organization Name | LIFEBRIDGE INVESTMENTS, INC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QE0800X |
Clinic/Center Specialization: Endoscopy |
Ambulatory Health Care Facilities | ||
Y | 261QE0800X |
Clinic/Center Specialization: Endoscopy |
A | MD | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MD | 417384800 | 05 |
Other Name | Type Code |
---|---|
LifeBridge Community Practices, LLC d/b/a Clinical Associates ASC | Doing Business As Name - Organization |
Street Address |
515 FAIRMOUNT AVE STE 100A |
City | TOWSON |
State | MD |
Zip Code | 21286-5466 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013910454 | David S. Berliner | Internal Medicine | 515 Fairmount Ave, Ste 400, Towson, MD 21286-5466 | 2005-05-31 |
1598253403 | Courtney Alyse Mcguire | Occupational Therapy Assistant | 515 Fairmount Ave, Towson, MD 21286-5466 | 2018-04-25 |
1699280511 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286 | 2017-12-14 |
1497296271 | Candice Korolevich | Nurse Practitioner | 515 Fairmount Ave, Towson, MD 21286 | 2017-03-14 |
1124572763 | Gps Physician Group of Texas Pllc | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286-5466 | 2016-08-11 |
1659737898 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286-5466 | 2016-01-04 |
1184095267 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286-5466 | 2015-10-14 |
1104297852 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286-5466 | 2015-10-07 |
1982074001 | Clinical Associates P A | Clinic/Center | 515 Fairmount Ave, Ste 100a, Towson, MD 21286-5466 | 2015-10-01 |
1417344284 | Genesis Staffing Services, LLC | Community/Behavioral Health | 515 Fairmount Ave, 8th Floor, Towson, MD 21286-5466 | 2015-04-20 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750989042 | Osereme Nora Agboifo | Nurse Practitioner | 200 Ejoppa Rd Suite 106, Townson, MD 21286 | 2020-10-09 |
1801434543 | Bh Brightview Towson Opco, LLC | Alzheimer Center (Dementia Center) | 20 E. Burke Avenue, Baltimore, MD 21286 | 2019-12-12 |
1417598897 | Tyler Tuggle | Home Health Aide | 8601 Lasalle Rd., Suite 100, Towson, MD 21286 | 2019-10-07 |
1285289629 | Center for Creative Values Inc | Community/Behavioral Health | 515 E. Joppa Rd Suite 100 & 104, Towson, MD 21286 | 2019-08-02 |
1275195117 | Watermark Health Services | Chore Provider | 1045 Taylor Avenue Suite 106e, Towson, MD 21286 | 2019-07-01 |
1609337021 | Tyler James Howard | Psychologist | 8600 Lasalle Road Carroll Building, Suite 212, Towson, MD 21286 | 2019-03-28 |
1477019578 | Ruth Marie Collins | Counselor | 8501 Lasalle Rd., Suite 115, Towson, MD 21286 | 2019-02-13 |
1396200671 | Christian Dorry | Behavior Technician | Epic Developmental Services, 1026 Cromwell Bridge Rd, Towson, MD 21286 | 2019-01-31 |
1831667799 | Casey O'sullivan | Counselor | 1220 E. Joppa Rd., Bldg B, Ste 332, Towson, MD 21286 | 2018-11-08 |
1649763053 | Rosemary O Okpulor | Nurse Practitioner | 8510 Lasalle Rd, Suite 310, Towson, MD 21286 | 2018-06-11 |
Find all providers in zip 21286 |
Taxonomy Code | 261QE0800X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Endoscopy |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982074001 | Clinical Associates P A | Clinic/Center | 515 Fairmount Ave, Ste 100a, Towson, MD 21286-5466 | 2015-10-01 |
1811934573 | Endoscopic Microsurgery Associates | Clinic/Center | 7402 York Rd, Suite 100, Towson, MD 21204-7532 | 2006-06-01 |
1508813197 | Endoscopy Center At Towson, Inc | Clinic/Center | 7402 York Rd, Suite 101, Towson, MD 21204-7532 | 2006-05-28 |
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1689212151 | Civista Clinical Services, LLC | Clinic/Center | 5 N La Plata Ct Ste 201, La Plata, MD 20646-5208 | 2019-12-16 |
1699219766 | Calvert Digestive Disease Associates, Endoscopy and Surgery Center LLC | Clinic/Center | 985 Prince Frederick Blvd Ste 104, Prince Frederick, MD 20678-3490 | 2016-12-08 |
1013372986 | Gi Wellness Center of Frederick, LLC | Clinic/Center | 165 Thomas Johnson Dr, Suite B&c, Frederick, MD 21702-4742 | 2015-12-21 |
1942462064 | Jonathan Mccone Jr. Md PC | Clinic/Center | 6196 Oxon Hill Rd Ste 640, Oxon Hill, MD 20745 | 2008-06-30 |
1386614832 | Carroll County Digestive Disease Center, LLC | Clinic/Center | 216b Washington Heights Med Ctr, Westminster, MD 21157-5633 | 2006-01-26 |
1215287156 | Eastern Shore Endoscopy, LLC | Clinic/Center | 511 Idlewild Ave, Easton, MD 21601-3888 | 2012-09-19 |
1083855092 | Maryland Diagnostic and Therapeutic Endo Center, LLC | Clinic/Center | 621 Ridgely Ave, Suite 105, Annapolis, MD 21401-1081 | 2009-03-20 |
1013170521 | Greenbelt Endoscopy Center, LLC | Clinic/Center | 9821 Greenbelt Rd, Ste 103, Lanham, MD 20706-6240 | 2008-07-03 |
1821115700 | Urbana Gi Endoscopy Center, LLC | Clinic/Center | 3280 Urbana Pike, Suite 104, Ijamsville, MD 21754 | 2007-03-23 |
1831214717 | Advanced Endoscopy Center of Howard County, LLC | Clinic/Center | 8875 Centre Park Dr, Ste D, Columbia, MD 21045-2114 | 2007-03-20 |
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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.