97TH MEDGRP-ALTUS
NPI 1093782880
Clinic/Center - Military/U.S. Coast Guard Outpatient in Altus Afb, OK

Active since March 01, 2006
301 N 1ST ST, BLDG 46, ALTUS AFB, OK 73523(580) 481-5400(580) 481-5416 Get Directions Write a Review

NPPES record last updated: June 17, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 17, 2025, Mar 12, 2025, Feb 19, 2025 (3 updates tracked since 2025).

About 97th Medgrp-altus NPPES

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

97TH MEDGRP-ALTUS (NPI 1093782880) is a healthcare organization registered as a military/u.s. coast guard outpatient in Altus Afb, Oklahoma and active in the NPI registry since March 2006. The organization lists Jen Lewandowski, Dha Ubo, as its authorized official.

NPPES Registry Identity

NPI1093782880
Entity TypeOrganization
Primary Taxonomy261QM1100X
Legal Business Name97TH MEDGRP-ALTUS
Location Address301 N 1ST ST, BLDG 46Altus Afb, OK 73523-5004
Mailing Address301 N 1st St, Bldg 46Altus Afb, OK 73523-5004 · (580) 481-5400 · Fax (580) 481-5416
Fax(580) 481-5416
Organization SubpartYes
Authorized OfficialJen LewandowskiDha Ubo · (703) 817-4030
Enumeration DateMarch 1, 2006
Last NPPES UpdateJune 17, 20253 updates tracked since enumeration
NPPES CertifiedJune 17, 2025
NPI 1093782880 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Military/U.S. Coast Guard OutpatientAmbulatory Health Care Facilities
Taxonomy Code261QM1100X
Definition
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.
301 N 1ST ST, Altus Afb, OK 73523

Other Identifiers 1

Other3720225OK · Ncpdp

Other Providers at the Same Location NPPES 20

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

Dentist
301 N 1ST ST
ALTUS, OK 73523
Social Worker (Clinical)
301 N 1ST ST
ALTUS AFB, OK 73523
Dentist
301 N 1ST ST
ALTUS AFB, OK 73523
Preventive Medicine (Occupational Medicine)
301 N 1ST ST
ALTUS AFB, OK 73523
Psychiatry & Neurology (Psychiatry)
301 N 1ST ST
ALTUS, OK 73523
Registered Nurse (Ambulatory Care)
301 N 1ST ST
ALTUS AFB, OK 73523
Family Medicine
301 N 1ST ST
ALTUS, OK 73523
Pharmacist
301 N 1ST ST
ALTUS AFB, OK 73523

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 97th Medgrp-Altus's NPI number?

The NPI number for 97th Medgrp-Altus is 1093782880. It was assigned to this organization in the NPPES registry on March 1, 2006.

Where is 97th Medgrp-Altus located?

97th Medgrp-Altus is located at 301 N 1st St Bldg 46, Altus Afb, OK 73523. The listed phone number is (580) 481-5400.

What is 97th Medgrp-Altus's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Military/U.S. Coast Guard Outpatient, with taxonomy code 261QM1100X.

When was this NPI record last updated?

The NPPES record for 97th Medgrp-Altus was last updated on June 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.