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49TH MEDGRP-HOLLOMAN
NPI 1952374910
Clinic/Center - Military/U.S. Coast Guard Outpatient in Holloman Afb, NM

Active since February 09, 2006
280 1ST ST, SGSR, HOLLOMAN AFB, NM 88330(505) 572-5744(505) 572-0549 Get Directions Write a Review

NPPES record last updated: July 3, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

About 49th Medgrp-holloman NPPES

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

49TH MEDGRP-HOLLOMAN (NPI 1952374910) is a healthcare organization registered as a military/u.s. coast guard outpatient in Holloman 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

NPI1952374910
Entity TypeOrganization
Primary Taxonomy261QM1100X
Legal Business Name49TH MEDGRP-HOLLOMAN
Location Address280 1ST ST, SGSRHolloman Afb, NM 88330-8273
Mailing Address280 1st St, SgsrHolloman Afb, NM 88330-8273 · (505) 572-5744 · Fax (505) 572-0549
Phone(505) 572-5744
Fax(505) 572-0549
Organization SubpartYes
Authorized OfficialJen LewandowskiDha Ubo · (703) 817-4030
Enumeration DateFebruary 9, 2006
Last NPPES UpdateJuly 3, 20253 updates tracked since enumeration
NPPES CertifiedJuly 3, 2025
✔ NPI 1952374910 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
280 1ST ST, Holloman Afb, NM 88330
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Other Names 1

Other NameHolloman Afb Mtf

Other Identifiers 1

Other3210010NM · 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.

MS. ANNE CHRISTINE RIVERA RD
Dietitian, Registered
280 1ST ST, 49MDG/SGPZ
HOLLOMAN AFB, NM 88330
Otero County (575) 572-6047
DR. FRANK JOSEPH EMMERT DDS
Dentist
280 1ST ST, BLDG 20
HOLLOMAN AFB, NM 88330
Otero County (575) 572-3742
MR. SAMUEL HENRY PATTON
Counselor (Addiction (Substance Use Disorder))
280 1ST ST, 49 MEDICAL GROUP
HOLLOMAN AFB, NM 88330
Otero County (575) 572-5676
JEROME CARLOS MALIMBAN PT, DPT
Physical Therapist
280 1ST ST
HOLLOMAN AFB, NM 88330
Otero County (575) 572-0899
JENNIFER PEI WANG
Pharmacist
280 1ST ST
HOLLOMAN AFB, NM 88330
Otero County (917) 939-3819
OLIVER NELS-ANDER MULLINS O.D.
Optometrist
280 1ST ST
HOLLOMAN AFB, NM 88330
Otero County (575) 572-3564
MRS. DERANDORIA ANN YOUNG MSW
Social Worker (Clinical)
280 1ST ST, BLDG 17
HOLLOMAN AFB, NM 88330
Otero County (575) 572-7061
JANA JOEL MCBURNEY NP-C
Nurse Practitioner (Family)
280 1ST ST
HOLLOMAN AFB, NM 88330
Otero County (575) 572-3041

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 49th Medgrp-Holloman's NPI number?

The NPI number for 49th Medgrp-Holloman is 1952374910. It was assigned to this organization in the NPPES registry on February 9, 2006. The provider is also known as Holloman AFB MTF.

Where is 49th Medgrp-Holloman located?

49th Medgrp-Holloman is located at 280 1st St Sgsr, Holloman Afb, NM 88330. The listed phone number is (505) 572-5744.

What is 49th Medgrp-Holloman'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 49th Medgrp-Holloman was last updated on July 3, 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.