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DR. JACALYN BLACKWELL-WHITE
NPI 1194170027
Pediatrics - Adolescent Medicine in Randallstown, MD

Active since April 28, 2016
5400 OLD COURT RD STE 300B, RANDALLSTOWN, MD 21133(410) 521-7337(410) 521-7377 Get Directions Write a Review

NPPES record last updated: August 31, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 15, 2019, Nov 1, 2016, Jun 25, 2016 (3 updates tracked since 2016).

About Dr. Jacalyn Blackwell-white NPPES

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

DR. JACALYN BLACKWELL-WHITE (NPI 1194170027) is a healthcare organization registered as an adolescent medicine in Randallstown, Maryland and active in the NPI registry since April 2016. The organization maintains a secondary practice location in Baltimore and lists Mary Wright-sisk, Director, as its authorized official.

NPPES Registry Identity

NPI1194170027
Entity TypeOrganization
Primary Taxonomy2080A0000X
Legal Business NameLIFEBRIDGE SUBURBAN PHYSICIAN GROUP II LLC
Location Address5400 OLD COURT RD STE 300BRandallstown, MD 21133-5100
Mailing Address3527 N Rolling Rd, # 1Baltimore, MD 21244-2223 · (410) 521-7337
Phone(410) 521-7337
Fax(410) 521-7377
Organization SubpartYesParent: Lifebridge Community Physicians, Inc.
Authorized OfficialMary Wright-siskDirector · (443) 422-9941
Enumeration DateApril 28, 2016
Last NPPES UpdateAugust 31, 20213 updates tracked since enumeration
NPPES CertifiedAugust 31, 2021
✔ NPI 1194170027 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
5400 OLD COURT RD STE 300B, Randallstown, MD 21133
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Other Names 1

Doing Business AsDr. Jacalyn Blackwell-white

Secondary Practice Location 1

Location 13527 N Rolling Rd, # 1Baltimore, MD 21244-2223 · Phone (410) 521-7337

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

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

SINAI HOSPITAL OF BALTIMORE INC
Pediatrics
5400 OLD COURT RD STE 300B
RANDALLSTOWN, MD 21133
Baltimore County (410) 521-7337
LIFEBRIDGE COMMUNITY PHYSICIANS INC
Family Medicine
5400 OLD COURT RD STE 300B
RANDALLSTOWN, MD 21133
Baltimore County (410) 521-7377
DR. JACALYN CECELIA BLACKWELL-WHITE M.D.
Pediatrics (Adolescent Medicine)
5400 OLD COURT RD STE 300B
RANDALLSTOWN, MD 21133
Baltimore County (410) 521-7337
LIFEBRIDGE COMMUNITY PHYSICIANS, INC
Family Medicine
5400 OLD COURT RD STE 300B
RANDALLSTOWN, MD 21133
Baltimore County (410) 521-7337
MRS. BARNITTA LATRICIA MOSES CPNP
Nurse Practitioner (Pediatrics)
5400 OLD COURT RD STE 300B
RANDALLSTOWN, MD 21133
Baltimore County (410) 521-7337

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 Lifebridge Suburban Physician Group II LLC's NPI number?

The NPI number for Lifebridge Suburban Physician Group II LLC is 1194170027. It was assigned to this organization in the NPPES registry on April 28, 2016. The provider is doing business as Dr. Jacalyn Blackwell-White.

Where is Lifebridge Suburban Physician Group II LLC located?

Lifebridge Suburban Physician Group II LLC is located at 5400 Old Court Rd Ste 300B, Randallstown, MD 21133. The listed phone number is (410) 521-7337.

What is Lifebridge Suburban Physician Group II LLC's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

When was this NPI record last updated?

The NPPES record for Lifebridge Suburban Physician Group II LLC was last updated on August 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.