LIFEBRIDGE COMMUNITY PHYSICIANS, INC. (NPI# 1891247003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891247003 |
| Entity Type | Organization |
| Organization Name | LIFEBRIDGE COMMUNITY PHYSICIANS, INC. |
| Other Organization Name | BW PRIMARY CARE, LLC |
| Practice Address |
6190 Georgetown Blvd Suite 104 Eldersburg MD 21784-6460 |
| Practice Telephone | 4105525050 |
| Practice Fax Number | 4105520200 |
| Mailing Telephone | 4105525050 |
| Mailing Fax Number | 4105520200 |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2017-03-22 |
| Authorized Official Name | MARY R WRIGHT-SISK (DIRECTOR) |
| Authorized Official Telephone | 4107014439 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| BW Primary Care, LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124486337 | Lifebridge Community Physicians, Inc. | Family Medicine | 688 Poole Rd, Westminster, MD 21157-6166 | 2016-02-02 |
| 1336684505 | Lifebridge Community Physicians, Inc. | Surgery | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2016-12-27 |
| 1194275453 | Lifebridge Community Physicians, Inc. | Internal Medicine | 1838 Greene Tree Rd, Suite 300, Pikesville, MD 21208-6391 | 2016-10-11 |
| 1508225798 | Lifebridge Community Physicians, Inc. | Internal Medicine | 849 Fairmont Avenue, Suite 100b, Towson, MD 21286-2600 | 2016-02-16 |
| 1912364076 | Lifebridge Community Physicians, Inc. | Internal Medicine | 8600 Liberty Rd, Randallstown, MD 21133-4707 | 2016-01-20 |
| Street Address |
6190 GEORGETOWN BLVD SUITE 104 |
| City | ELDERSBURG |
| State | MD |
| Zip Code | 21784-6460 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427042027 | Jill Marie Koeppen | Nurse Practitioner | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2005-09-09 |
| 1255941522 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2020-08-03 |
| 1033755434 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2019-11-20 |
| 1245892819 | Kristen Allard | Registered Nurse | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2019-07-03 |
| 1265908446 | Crystal Olivia Leonard | Nurse Practitioner | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2018-10-16 |
| 1578055497 | Lifebridge Sports Medicine and Rehabilitation LLC | Clinic/Center | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2018-06-06 |
| 1841732047 | Melissa Bassett | Nurse Practitioner | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2016-11-06 |
| 1730539289 | Jay Steven Orr | Family Medicine | 6190 Georgetown Blvd, Eldersburg, MD 21784 | 2016-06-15 |
| 1649662776 | Genna Sellers | Nurse Practitioner | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2015-02-26 |
| 1386049260 | Fatemeh Jafari Farshami | Student in an Organized Health Care Education/Training Program | 6190 Georgetown Blvd, Suite 110, Eldersburg, MD 21784 | 2014-11-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033681085 | Kathleen Busching | Occupational Therapy Assistant | Intergrace Fairhaven, 7200 Third Ave, Sykesville, MD 21784 | 2018-12-31 |
| 1619450376 | Mackenzie Fleming | Counselor | 6220 Georgetown Blvd Suite C, Eldersburg, MD 21784 | 2018-09-10 |
| 1316426919 | Rebecca Rubin | Nurse Practitioner | 1380 Progress Way, Suite 102, Eldersburg, MD 21784 | 2018-08-14 |
| 1417473273 | Andrey Doroshenko | Dentist | 1722 Underwood Road, Sykesville, MD 21784 | 2017-08-14 |
| 1992229694 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 6400 Georgetown Blvd, Eldersburg, MD 21784 | 2017-08-03 |
| 1457894495 | Bethany Six | Nurse Practitioner | 6190 Gerogetown Blvd, Eldersburg, MD 21784 | 2016-11-23 |
| 1982011821 | Fast Track Urgent Care, LLC | Clinic/Center | 1315 Breton Drive, Eldersburg, MD 21784 | 2014-07-11 |
| 1588097984 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 5961 Exchange Dr, Suite 100, Eldersburg, MD 21784 | 2013-08-21 |
| 1356690986 | Kayla Nicole Koster | Speech-Language Pathologist | 1702 Liberty Road, First Floor, Sykesville, MD 21784 | 2012-08-29 |
| 1558645663 | Fusion Dental | Dentist | 5959 Exchange Drive, Suite 116, Eldersburg, MD 21784 | 2011-10-07 |
| Find all providers in zip 21784 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730539289 | Jay Steven Orr | Family Medicine | 6190 Georgetown Blvd, Eldersburg, MD 21784 | 2016-06-15 |
| 1750696985 | Sinai Hospital of Baltimore, Inc | Family Medicine | 6190 Georgetown Blvd, Suite 103, Eldersburg, MD 21784-6460 | 2010-08-12 |
| 1215120951 | Carrolltowne Medical Center P.a. | Family Medicine | 1380 Progress Way, Suite112, Eldersburg, MD 21784-6464 | 2007-08-27 |
| 1427189174 | Carroll Primary Care, Pa | Family Medicine | 1380 Progress Way, Suite 114, Eldersburg, MD 21784-6464 | 2007-03-07 |
| 1467581488 | Janet Denise Little | Family Medicine | 1311 Londontown Blvd, Suite 130, Eldersburg, MD 21784-6454 | 2007-03-05 |
| 1306909411 | Steven Billet, M.d.p.a. | Family Medicine | 1137 Liberty Rd, Eldersburg, MD 21784-7934 | 2006-12-19 |
| 1073691192 | Elizabeth A Pallan | Family Medicine | 1380 Progress Way, Suite 114, Eldersburg, MD 21784-6464 | 2006-11-02 |
| 1477631505 | Pamela A Pagano-pickrel | Family Medicine | 1380 Progress Way, Suite 114, Eldersburg, MD 21784-6464 | 2006-11-02 |
| 1669558219 | Michael K Mcevoy | Family Medicine | 1380 Progress Way, Suite 114, Eldersburg, MD 21784-6464 | 2006-10-27 |
| 1285645747 | Randi E Braman | Family Medicine | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2006-08-10 |
| Find all providers in ELDERSBURG | ||||
| City | ELDERSBURG |
| Zip Code | 21784 |
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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.