LIFEBRIDGE SPORTS MEDICINE & REHABILITATION LLC (NPI# 1922396100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922396100 |
| Entity Type | Organization |
| Organization Name | LIFEBRIDGE SPORTS MEDICINE & REHABILITATION LLC |
| Practice Address |
9712 Belair Rd Suite 101 Nottingham MD 21236-1111 |
| Mailing Address |
Po Box 1245 Indiana PA 15701-5245 |
| Practice Telephone | 4102567070 |
| Practice Fax Number | 4102567077 |
| 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 |
| 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 |
9712 BELAIR RD SUITE 101 |
| City | NOTTINGHAM |
| State | MD |
| Zip Code | 21236-1111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588814081 | Preston Mann Gazaway IIi | Obstetrics & Gynecology | 9712 Belair Rd, Suite 301, Nottingham, MD 21236-1103 | 2008-09-22 |
| 1437161445 | Henning & Cole Therapy Associates, Ltd. | Occupational Therapist | 9712 Belair Rd, Suite 101-a, Nottingham, MD 21236-1103 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699381467 | Monique Gaston | Counselor | Well Life Counseling and Consulting, 9649 Belair Road, Ste. 104, Nottingham, MD 21236 | 2020-09-17 |
| 1215575519 | Bh Brightview Perry Hall Opco, LLC | Alzheimer Center (Dementia Center) | 9657 Belair Road, Nottingham, MD 21236 | 2019-12-17 |
| 1750929493 | Bh Brightview White Marsh Opco, LLC | Alzheimer Center (Dementia Center) | 8100 Rossville Blvd., Baltimore, MD 21236 | 2019-12-12 |
| 1083257646 | Matthew Peter Halstad | Behavioral Analyst | 8090 Sandpiper Circle, Nottingham, MD 21236 | 2019-10-25 |
| 1609331602 | Tunisia Buise | Social Worker | 4132 E. Joppa Road Ste. 110-#1248, Baltimore, MD 21236 | 2019-02-04 |
| 1730673047 | Golden Jemz Adult Medical Day | Clinic/Center | 5020 Cambell Blvd, Nottingham, MD 21236 | 2018-06-20 |
| 1487143400 | For Eyes Optical of Pa | Eyewear Supplier (Equipment, not the service) | 7984 Honeygo Blvd, Nottingham, MD 21236 | 2018-05-04 |
| 1619478922 | Weis Markets, Inc. | Pharmacy | 7927 Belair Rd Ste S, Nottingham, MD 21236 | 2018-02-22 |
| 1285133918 | Joan Rosa Keller | Behavior Technician | 3501 Taylor Ave., Baltimore, MD 21236 | 2018-02-08 |
| 1205341146 | Ebony Watkins | Nurse Practitioner | 8940 Kilkenny Circle, Nottingham, MD 21236 | 2017-12-13 |
| Find all providers in zip 21236 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427669159 | Phaze Counseling Services Inc | Clinic/Center | 4425 Fitch Ave Ste 118, Nottingham, MD 21236-3927 | 2020-08-14 |
| 1659769909 | The Johns Hopkins Hospital | Clinic/Center | 4924 Campbell Boulevard, Suite 130a, Nottingham, MD 21236-5909 | 2015-01-08 |
| 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 |
| 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 |
| 1942862602 | Royal Minds Inc. | Clinic/Center | 3717 E Baltimore St, Baltimore, MD 21224-1509 | 2019-07-02 |
| Find all providers with the same taxonomy | ||||
| City | NOTTINGHAM |
| Zip Code | 21236 |
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.