19TH Medgrp-Little Rock

Primary specialty

Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X

Legal business name

19TH MEDGRP-LITTLE ROCK

Practice address

1090 Arnold Dr
LR AFB, AR 72099-4933

Phone

(501) 987-7414

Fax

(501) 987-7310

NPI assigned

Jan 3, 2006

Last updated

Jun 16, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

19TH MEDGRP-LITTLE ROCKAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jen Lewandowski

Title

Air Force Ubo Analyst

Phone

(703) 817-4030

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Little Rock AFB MTF Other name

Tax ID family

19TH Medgrp-Little Rock2 organizations share this tax ID, including this one

Part of

19TH Medgrp-Little Rock

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• 19TH Medgrp-Little Rock

  dba DoD LITTLE ROCK ePhcy

  • Military/U.S. Coast Guard Pharmacy
  • Little Rock AFB, AR
  • NPI 1841606936
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750032000000",
    "number": "1073591830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 ARNOLD DR",
            "city": "LR AFB",
            "state": "AR",
            "postal_code": "720994933",
            "telephone_number": "501-987-7414",
            "fax_number": "501-987-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 ARNOLD DR",
            "city": "LR AFB",
            "state": "AR",
            "postal_code": "720994933",
            "telephone_number": "501-987-7414",
            "fax_number": "501-987-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "19TH MEDGRP-LITTLE ROCK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "19TH MEDGRP-LITTLE ROCK",
        "enumeration_date": "2006-01-03",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A",
        "authorized_official_last_name": "LEWANDOWSKI",
        "authorized_official_first_name": "JEN",
        "authorized_official_title_or_position": "AIR FORCE UBO ANALYST",
        "authorized_official_telephone_number": "703-817-4030"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1101X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332000000X",
            "taxonomy_group": "",
            "desc": "Military/U.S. Coast Guard Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "420846",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Little Rock AFB MTF",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Thomas Gerald Brown, PH.D.
• Lauren Elizabeth Fehr
• Alyson Greenwood, PHARMD
• Christopher John Hoar, IDMT
• Phillip Dakotah Mitchell

• Military/U.S. Coast Guard Outpatient Clinic/Center in LR AFB, AR
• Providers in LR AFB, AR by specialty
• Military/U.S. Coast Guard Outpatient Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.