97TH MEDGRP-ALTUS
NPI 1093782880
Clinic/Center - Military/U.S. Coast Guard Outpatient in Altus Afb, OK
NPI Status: Active since March 01, 2006
Contact Information
301 N 1ST ST
BLDG 46
ALTUS AFB, OK
ZIP 73523
Phone: (580) 481-5400
Fax: (580) 481-5416
- Organization
- Clinic/Center
- Military/U.S. Coast Guard Outpatient
- Accepts Insurance
About 97TH MEDGRP-ALTUS
This page provides the complete NPI Profile along with additional information for 97th Medgrp-altus, a provider established in Altus Afb, Oklahoma operating as a Clinic/center, focusing in military/u.s. coast guard outpatient . The healthcare provider is registered in the NPI registry with number 1093782880 assigned on March 2006. The practitioner's primary taxonomy code is 261QM1100X. The provider is registered as an organization and their NPI record was last updated June 2025. The authorized official of this NPI record is Jen Lewandowski (Dha Ubo)
- NPI
- 1093782880
- Provider Name
- 97TH MEDGRP-ALTUS
- Entity Type
- Organization
- Location Address
- 301 N 1ST ST BLDG 46 ALTUS AFB, OK 73523
- Location Phone
- (580) 481-5400
- Location Fax
- (580) 481-5416
- Mailing Address
- 301 N 1ST ST BLDG 46 ALTUS AFB, OK 73523
- Mailing Phone
- (580) 481-5400
- Mailing Fax
- (580) 481-5416
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 03-01-2006
- Last Update Date
- 06-17-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Military/U.S. Coast Guard Outpatient
- Taxonomy Code
- 261QM1100X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- The Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? Standard - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3720225 | OTHER (01) | OK | NCPDP |
Reviews for 97TH MEDGRP-ALTUS
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 9 | 3 | 7 | 8 | 2 | 8 | 8 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 18 | 3 | 14 | 8 | 4 | 8 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 8 + 3 + 1 + 4 + 8 + 4 + 8 + 1 + 6 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1093782880 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
CHRISTINA S HONG
Pharmacist
301 N 1ST ST
ALTUS AFB, OK
ZIP 73523
ALTUS PHCY 97TH MDG
Military/U.S. Coast Guard Pharmacy
301 N 1ST ST
ALTUS AFB, OK
ZIP 73523
DEPARTMENT OF DEFENSE-AIR FORCE
Military/U.S. Coast Guard Pharmacy
301 N 1ST ST
BLDG 46
ALTUS AFB, OK
ZIP 73523
DR. NGUYEN T NGUYEN PHARMD
Pharmacist
301 N 1ST ST
ALTUS AFB, OK
ZIP 73523
DR. ALEXANDRA E HERNANDEZ DDS
Dentist
301 N 1ST ST
ALTUS, OK
ZIP 73523
DR. JAMES ROBERT CAMPBELL III M.D.
Pediatrics
301 N 1ST ST
ALTUS, OK
ZIP 73523
CHRISTOPHER LILLENBERG DDS
Dentist
301 N 1ST ST
ALTUS AFB, OK
ZIP 73523
MRS. RILEY SOLOMON IDMT
Military Health Care Provider
(Independent Duty Medical Technicians)
301 N 1ST ST
BLDG 46
ALTUS, OK
ZIP 73523
ISAAC YOURISON
Family Medicine
301 N 1ST ST
ALTUS, OK
ZIP 73523
CHASE LEAVY DPT
Physical Therapist
301 N 1ST ST
ALTUS AFB, OK
ZIP 73523
MRS. SANDRA H STUART MS, RDN, CSSD, LD
Dietitian, Registered
(Nutrition, Sports Dietetics)
301 N 1ST ST
ALTUS AFB, OK
ZIP 73523
ELIZABETH SIOK DMD
Dentist
(General Practice)
301 N 1ST ST
ALTUS, OK
ZIP 73523
DR. MARILYN THUY LAI O.D.
Optometrist
301 N 1ST ST
ALTUS AFB, OK
ZIP 73523
KATON RANS HARWOOD DO
Preventive Medicine
(Aerospace Medicine)
301 N 1ST ST
ALTUS AFB, OK
ZIP 73523
SPENCER LANG
Dentist
301 N 1ST ST
ALTUS, OK
ZIP 73523
JULIANNE RODGERS SHYTLE PHARMD
Pharmacist
301 N 1ST ST
ALTUS, OK
ZIP 73523
DR. STEVEN EDWARD KOEHL D.O.
Psychiatry & Neurology
(Psychiatry)
301 N 1ST ST
ALTUS, OK
ZIP 73523
SUNNYE ELIZABETH COPE LCSW
Social Worker
(Clinical)
301 N 1ST ST
ALTUS AFB, OK
ZIP 73523
DR. KATELIN ELISE THAI D.O.
Preventive Medicine
(Occupational Medicine)
301 N 1ST ST
ALTUS AFB, OK
ZIP 73523
CHANDA TE'NEIL MIRANDA RN, BSN
Registered Nurse
(Ambulatory Care)
301 N 1ST ST
ALTUS AFB, OK
ZIP 73523
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1093782880, enumerated as an "organization" on March 01, 2006.
The provider is located at 301 N 1ST ST BLDG 46 ALTUS AFB, OK 73523 and the phone number is (580) 481-5400.
Clinic/Center with taxonomy code 261QM1100X and a focus in Military/U.S. Coast Guard Outpatient.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Oklahoma, Medicare. Please consult your insurance carrier or call the provider to verify.
