412TH MEDGRP-EDWARDS
NPI 1891765046
Clinic/Center - Military/U.S. Coast Guard Outpatient in Edwards Afb, CA

Q: What is 412th Medgrp-Edwards's NPI number?

The NPI number for 412th Medgrp-Edwards is 1891765046. It was assigned to this organization in the NPPES registry on January 23, 2006.

Q: What is 412th Medgrp-Edwards's specialty?

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

Active since January 23, 2006

30 NIGHTINGALE RD, BLDG 5525, EDWARDS AFB, CA 93524(661) 275-2634(661) 277-6645 Get Directions Write a Review

NPPES record last updated: June 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 16, 2025, Jun 12, 2025 (2 updates tracked since 2025).

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About 412th Medgrp-edwards NPPES

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

412TH MEDGRP-EDWARDS (NPI 1891765046) is a healthcare organization registered as a military/u.s. coast guard outpatient in Edwards Afb, California and active in the NPI registry since January 2006. The organization lists Jen Lewandowski, Air Force Ubo Analyst, as its authorized official.

NPPES Registry Identity

NPI1891765046

Entity TypeOrganization

Primary Taxonomy261QM1100X

Legal Business Name412TH MEDGRP-EDWARDS

Location Address30 NIGHTINGALE RD, BLDG 5525Edwards Afb, CA 93524-0001

Mailing Address30 Nightingale Rd, Bldg 5525Edwards Afb, CA 93524-0001 · (661) 275-2634 · Fax (661) 277-6645

Phone(661) 275-2634

Fax(661) 277-6645

Organization SubpartYes

Authorized OfficialJen LewandowskiAir Force Ubo Analyst · (703) 817-4030

Enumeration DateJanuary 23, 2006

Last NPPES UpdateJune 16, 20252 updates tracked since enumeration

NPPES CertifiedJune 16, 2025

✔ NPI 1891765046 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 ListedClinic/Center · Military and U.S. Coast Guard Ambulatory ProcedureTaxonomy 261QM1101X

Also ListedMilitary/U.S. Coast Guard PharmacyTaxonomy 332000000X

30 NIGHTINGALE RD, Edwards Afb, CA 93524

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Other Identifiers 1

Other05-40345CA · Ncpdp

Other Providers at the Same Location NPPES 13

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

PIOTR WOJCIECH PODLESNY M.D.

Family Medicine

30 NIGHTINGALE RD, 412MDOS/SGOP FAMILY HEALTH CLINIC
EDWARDS AFB, CA 93524

Kern County (661) 277-1172

JOEL DAVID REYES PA-C

Physician Assistant