27TH SPECIAL OPS MEDGRP-CANNON
NPI 1285606384
Clinic/Center - Military/U.S. Coast Guard Outpatient in Cannon Afb, NM

Active since February 02, 2006
208 W CASABLANCA AVE, 27 MDSS SGSR, CANNON AFB, NM 88103(505) 784-4023(505) 784-7749 Get Directions Write a Review

NPPES record last updated: June 17, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 17, 2025, Jun 12, 2025 (2 updates tracked since 2025).

About 27th Special Ops Medgrp-cannon NPPES

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

27TH SPECIAL OPS MEDGRP-CANNON (NPI 1285606384) is a healthcare organization registered as a military/u.s. coast guard outpatient in Cannon Afb, New Mexico and active in the NPI registry since February 2006. The organization lists Jen Lewandowski, Dha Ubo, as its authorized official.

NPPES Registry Identity

NPI1285606384
Entity TypeOrganization
Primary Taxonomy261QM1100X
Legal Business Name27TH SPECIAL OPS MEDGRP-CANNON
Location Address208 W CASABLANCA AVE, 27 MDSS SGSRCannon Afb, NM 88103-5009
Mailing Address208 W Casablanca Ave, 27 Mdss SgsrCannon Afb, NM 88103-5009 · (505) 784-4023 · Fax (505) 784-7749
Fax(505) 784-7749
Organization SubpartYes
Authorized OfficialJen LewandowskiDha Ubo · (703) 817-4030
Enumeration DateFebruary 2, 2006
Last NPPES UpdateJune 17, 20252 updates tracked since enumeration
NPPES CertifiedJune 17, 2025
NPI 1285606384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

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.

Also ListedMilitary/U.S. Coast Guard PharmacyTaxonomy 332000000X
208 W CASABLANCA AVE, Cannon Afb, NM 88103

Other Identifiers 1

Other3210185NM · Ncpdp

Other Providers at the Same Location NPPES 15

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

Nurse Practitioner (Family)
208 W CASABLANCA AVE, 27 MEDICAL GROUP BLDG 1400 CANNON AFB
CLOVIS, NM 88103
Preventive Medicine (Aerospace Medicine)
208 W CASABLANCA AVE, 27 SOMDG/FLIGHT MEDICINE, BLDG 1400
CANNON AFB, NM 88103
Pharmacist
208 W CASABLANCA AVE
CANNON AFB, NM 88103
Military Health Care Provider (Independent Duty Medical Technicians)
208 W CASABLANCA AVE, 27SOMDG
CANNON AFB, NM 88103
Military Health Care Provider (Independent Duty Medical Technicians)
208 W CASABLANCA AVE
CANNON AFB, NM 88103
Military Health Care Provider (Independent Duty Medical Technicians)
208 W CASABLANCA AVE
CLOVIS, NM 88103
Military Health Care Provider (Independent Duty Medical Technicians)
208 W CASABLANCA AVE
CANNON AFB, NM 88103
Dietitian, Registered
208 W CASABLANCA AVE, 27 SOMDG/SGPM
CANNON AFB, NM 88103

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285606384, enumerated as an "organization" on February 02, 2006.

The provider is located at 208 W CASABLANCA AVE 27 MDSS SGSR CANNON AFB, NM 88103 and the phone number is (505) 784-4023.

Clinic/Center with taxonomy code 261QM1100X and a focus in Military/U.S. Coast Guard Outpatient.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.