92D Medgrp-Fairchild

Primary specialty

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

Legal business name

92D MEDGRP-FAIRCHILD

Practice address

701 Hospital Loop
Fairchild Afb, WA 99011-8704

Phone

(509) 247-9264

Fax

(509) 247-3535

NPI assigned

Apr 4, 2006

Organization subpart

Yes

Parent organization

92D MEDGRP-FAIRCHILDAs 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

Dha Ubo

Phone

(703) 817-4030

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Fairchild AFB MTF Other name

Tax ID family

92D Medgrp-Fairchild2 organizations share this tax ID, including this one

Part of

92D Medgrp-Fairchild

Other organizations with this tax ID 1

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

• 92D Medgrp-Fairchild

  • Military/U.S. Coast Guard Pharmacy
  • Fairchild Afb, WA
  • NPI 1477652519
  NPD tax ID

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1104888288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 HOSPITAL LOOP",
            "city": "FAIRCHILD AFB",
            "state": "WA",
            "postal_code": "990118704",
            "telephone_number": "509-247-9264",
            "fax_number": "509-247-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 HOSPITAL LOOP",
            "city": "FAIRCHILD AFB",
            "state": "WA",
            "postal_code": "990118704",
            "telephone_number": "509-247-9264",
            "fax_number": "509-247-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "92D MEDGRP-FAIRCHILD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "92D MEDGRP-FAIRCHILD",
        "enumeration_date": "2006-04-04",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A",
        "authorized_official_last_name": "LEWANDOWSKI",
        "authorized_official_first_name": "JEN",
        "authorized_official_title_or_position": "DHA UBO",
        "authorized_official_telephone_number": "703-817-4030"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1101X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332000000X",
            "taxonomy_group": "",
            "desc": "Military/U.S. Coast Guard Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "49-24507",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairchild AFB MTF",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• 92D Medgrp-Fairchild
• Elizabeth Andrews, RN, BSN
• Alyssa Lynn Arena, MD
• Katie Beth Austin, PHARMD
• Jason Barkemeyer, PHARMD

• Military/U.S. Coast Guard Outpatient Clinic/Center in Fairchild Afb, WA
• Providers in Fairchild Afb, WA by specialty
• Military/U.S. Coast Guard Outpatient Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.