LIFEBRIDGE COMMUNITY GASTROENTEROLOGY, LLC
NPI 1205638087
Internal Medicine - Gastroenterology in Westminster, MD

Q: What is Lifebridge Community Gastroenterology, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Active since March 25, 2025CLIA 21D2285312 · Waiver

295 STONER AVE STE 204, WESTMINSTER, MD 21157(410) 602-7782(410) 602-9344 Get Directions Write a Review

NPPES record last updated: March 25, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Lifebridge Community Gastroenterology, Llc NPPES

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

LIFEBRIDGE COMMUNITY GASTROENTEROLOGY, LLC (NPI 1205638087) is a healthcare organization registered as a gastroenterology in Westminster, Maryland and active in the NPI registry since March 2025. The organization holds a CLIA Waiver certificate valid through July 10, 2027 and lists Mary Rebecca Wright-sisk, Director, as its authorized official.

NPPES Registry Identity

NPI1205638087

Entity TypeOrganization

Primary Taxonomy207RG0100X

Legal Business NameLIFEBRIDGE COMMUNITY GASTROENTEROLOGY, LLC

Location Address295 STONER AVE STE 204Westminster, MD 21157-5637

Mailing Address295 Stoner Ave Ste 204Westminster, MD 21157-5637 · (410) 602-7782 · Fax (410) 602-9344

Phone(410) 602-7782

Fax(410) 602-9344

Organization SubpartNo

Authorized OfficialMary Rebecca Wright-siskDirector · (443) 422-9941

Enumeration DateMarch 25, 2025

NPPES CertifiedMarch 25, 2025

✔ NPI 1205638087 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

295 STONER AVE STE 204, Westminster, MD 21157

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Other Names 1

Other NameLifebridge Community Gastroenterology, Llc At Stoner

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

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 21D2285312

Lifebridge Community Gastroenterology · Westminster, MD

Active · expires Jul 10, 2027

CLIA Number21D2285312

Laboratory TypePhysician Office

Certificate Effective DateJuly 11, 2025

Certificate Expiration DateJuly 10, 2027

Laboratory DirectorTodd Heller

Laboratory Phone(410) 236-8155

Laboratory LocationLifebridge Community Gastroenterology535 Old Westminster Pike Suite 101, Westminster, MD 21157

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

JOCELYN NIEMKIEWICZ PA-C

Physician Assistant (Medical)

295 STONER AVE STE 204
WESTMINSTER, MD 21157

Carroll County (410) 876-8332

SARAH MEGAN MOFFETT NP-C

Nurse Practitioner (Family)

295 STONER AVE STE 204
WESTMINSTER, MD 21157

Carroll County (410) 876-8332

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 Community Gastroenterology, LLC's NPI number?

The NPI number for Lifebridge Community Gastroenterology, LLC is 1205638087. It was assigned to this organization in the NPPES registry on March 25, 2025. The provider is also known as LifeBridge Community Gastroenterology, LLC at Stoner.

Where is Lifebridge Community Gastroenterology, LLC located?

Lifebridge Community Gastroenterology, LLC is located at 295 Stoner Ave Ste 204, Westminster, MD 21157. The listed phone number is (410) 602-7782.

What is Lifebridge Community Gastroenterology, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Does Lifebridge Community Gastroenterology, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2285312) is associated with this NPI, valid through July 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lifebridge Community Gastroenterology, LLC was last updated on March 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.