SIGNATURE HEALTHCARE AT MALLARD BAY
NPI 1114118494
Skilled Nursing Facility in Cambridge, MD

Active since August 05, 2007CLIA 21D0704734 · Waiver
520 GLENBURN AVE, CAMBRIDGE, MD 21613(410) 228-9191(410) 228-8350 Get Directions Write a Review

NPPES record last updated: September 2, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Signature Healthcare At Mallard Bay NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SIGNATURE HEALTHCARE AT MALLARD BAY (NPI 1114118494) is a healthcare organization registered as a skilled nursing facility in Cambridge, Maryland and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists John Harrison, Cfo, as its authorized official.

NPPES Registry Identity

NPI1114118494
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameLP CAMBRIDGE LLC
Location Address520 GLENBURN AVECambridge, MD 21613-1415
Mailing Address12201 Bluegrass PkwyLouisville, KY 40299-2361 · (502) 568-7800
Fax(410) 228-8350
Organization SubpartYesParent: Lp Cs Holdings Llc
Authorized OfficialJohn HarrisonCfo · (561) 627-0664
Enumeration DateAugust 5, 2007
Last NPPES UpdateSeptember 2, 2022
NPPES CertifiedSeptember 2, 2022
NPI 1114118494 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in MD · 09-006
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
520 GLENBURN AVE, Cambridge, MD 21613

Other Names 1

Doing Business AsSignature Healthcare At Mallard Bay

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D0704734

LP Cambridge LLC Dba Signature Healthcare · Cambridge, MD
Active · expires Aug 31, 2026
CLIA Number21D0704734
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorPatricia A. Johnson
Laboratory Phone(410) 228-9191
Laboratory LocationLP Cambridge LLC Dba Signature Healthcare520 Glenburn Avenue, Cambridge, MD 21613
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
520 GLENBURN AVE
CAMBRIDGE, MD 21613
Nurse Practitioner (Psychiatric/Mental Health)
520 GLENBURN AVE
CAMBRIDGE, MD 21613
Skilled Nursing Facility
520 GLENBURN AVE
CAMBRIDGE, MD 21613
Podiatrist
520 GLENBURN AVE
CAMBRIDGE, MD 21613
Skilled Nursing Facility
520 GLENBURN AVE
CAMBRIDGE, MD 21613
Internal Medicine
520 GLENBURN AVE
CAMBRIDGE, MD 21613
Optometrist
520 GLENBURN AVE
CAMBRIDGE, MD 21613

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is LP Cambridge LLC's NPI number?

The NPI number for LP Cambridge LLC is 1114118494. It was assigned to this organization in the NPPES registry on August 5, 2007. The provider is doing business as Signature Healthcare At Mallard Bay.

Where is LP Cambridge LLC located?

LP Cambridge LLC is located at 520 Glenburn Ave, Cambridge, MD 21613. The listed phone number is (410) 228-9191.

What is LP Cambridge LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does LP Cambridge LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D0704734) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for LP Cambridge LLC was last updated on September 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.