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LIFEBRIDGE COMMUNITY PEDIATRICS, LLC
NPI 1841081171
Pediatrics in Owings Mills, MD

Active since May 15, 2025CLIA 21D0216791 · Waiver
10084 REISTERSTOWN RD STE 200B, OWINGS MILLS, MD 21117(410) 526-7993(410) 526-5144 Get Directions Write a Review

NPPES record last updated: May 15, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lifebridge Community Pediatrics, Llc NPPES

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

LIFEBRIDGE COMMUNITY PEDIATRICS, LLC (NPI 1841081171) is a healthcare organization registered as a pediatrics in Owings Mills, Maryland and active in the NPI registry since May 2025. The organization holds a CLIA Waiver certificate valid through May 6, 2028 and lists Mary Rebecca Wright-sisk, Director, as its authorized official.

NPPES Registry Identity

NPI1841081171
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameLIFEBRIDGE COMMUNITY PEDIATRICS, LLC
Location Address10084 REISTERSTOWN RD STE 200BOwings Mills, MD 21117-4096
Mailing Address10084 Reisterstown Rd Ste 200bOwings Mills, MD 21117-4096 · (410) 526-7993 · Fax (410) 526-5144
Phone(410) 526-7993
Fax(410) 526-5144
Organization SubpartNo
Authorized OfficialMary Rebecca Wright-siskDirector · (443) 422-9941
Enumeration DateMay 15, 2025
NPPES CertifiedMay 15, 2025
✔ NPI 1841081171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
10084 REISTERSTOWN RD STE 200B, Owings Mills, MD 21117
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Other Names 1

Other NameMain Street Pediatrics At Owings Mills

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 21D0216791

Lifebridge Community Pediatrics Dba Main Street Pe · Owings Mills, MD
Active · expires May 6, 2028
CLIA Number21D0216791
Laboratory TypePhysician Office
Certificate Effective DateMay 7, 2026
Certificate Expiration DateMay 6, 2028
Laboratory DirectorDr. Sara N. Spinner-Block
Laboratory Phone(410) 526-7993
Laboratory LocationLifebridge Community Pediatrics Dba Main Street Pe10084 Reisterstown Road #200b, Owings Mills, MD 21117
CLIA data matches this NPI record on: 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.

DR. DANIEL D POLIAKOFF M.D.
Pediatrics
10084 REISTERSTOWN RD STE 200B
OWINGS MILLS, MD 21117
Baltimore County (410) 526-7993
TERESA FULLER MD
Pediatrics
10084 REISTERSTOWN RD STE 200B
OWINGS MILLS, MD 21117
Baltimore County (410) 526-7993
DR. NEVIN BODY D.O.
Pediatrics
10084 REISTERSTOWN RD STE 200B
OWINGS MILLS, MD 21117
Baltimore County (410) 526-7993
ASHLEY DUFF BURKE DO
Pediatrics
10084 REISTERSTOWN RD STE 200B
OWINGS MILLS, MD 21117
Baltimore County (410) 526-7993
DIANE ISAACSON CHARLES MD
Pediatrics
10084 REISTERSTOWN RD STE 200B
OWINGS MILLS, MD 21117
Baltimore County (410) 494-1369
DR. ANTHONY JOSEPH VAZZANO M.D.
Pediatrics
10084 REISTERSTOWN RD STE 200B
OWINGS MILLS, MD 21117
Baltimore County (410) 526-7993
DR. BONNIE LINDA ORZECH-NIXON M.D.
Pediatrics
10084 REISTERSTOWN RD STE 200B
OWINGS MILLS, MD 21117
Baltimore County (410) 526-7993

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 Pediatrics, LLC's NPI number?

The NPI number for Lifebridge Community Pediatrics, LLC is 1841081171. It was assigned to this organization in the NPPES registry on May 15, 2025. The provider is also known as Main Street Pediatrics at Owings Mills.

Where is Lifebridge Community Pediatrics, LLC located?

Lifebridge Community Pediatrics, LLC is located at 10084 Reisterstown Rd Ste 200B, Owings Mills, MD 21117. The listed phone number is (410) 526-7993.

What is Lifebridge Community Pediatrics, LLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

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

Yes. A Certificate of Waiver (number 21D0216791) is associated with this NPI, valid through May 6, 2028. 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 Pediatrics, LLC was last updated on May 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.