NPIMap

Organization Active NPI

436TH Medgrp-Dover

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Dover Afb, DE
National Provider Identifier
1437112646
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
436TH MEDGRP-DOVER
Practice address
300 Tuskegee Blvd
Dover Afb, DE 19902-5003
Phone
(302) 677-2649
Fax
(302) 677-2051
NPI assigned
Apr 10, 2006
Organization subpart
Yes
Parent organization
436TH MEDGRP-DOVERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X DE Primary
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center 261QM1101X DE
Military/U.S. Coast Guard Pharmacy 332000000X

Addresses

Primary practice location

300 Tuskegee Blvd
Dover Afb, DE 19902-5003

Mailing address

300 Tuskegee Blvd
Dover Afb, DE 19902-5003
Phone (302) 677-2649

Other identifiers 1

IdentifierTypeStateIssuer
08-03735OtherDENCPDP

Other names 1

  • Dover AFB MTF Other name

National Provider Directory

National Provider Directory
Tax ID family
436TH Medgrp-Dover2 organizations share this tax ID, including this one
Part of
436TH Medgrp-Dover

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750032000000",
    "number": "1437112646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TUSKEGEE BLVD",
            "city": "DOVER AFB",
            "state": "DE",
            "postal_code": "199025003",
            "telephone_number": "302-677-2649",
            "fax_number": "302-677-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TUSKEGEE BLVD",
            "city": "DOVER AFB",
            "state": "DE",
            "postal_code": "199025003",
            "telephone_number": "302-677-2649",
            "fax_number": "302-677-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "436TH MEDGRP-DOVER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "436TH MEDGRP-DOVER",
        "enumeration_date": "2006-04-10",
        "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": "DE",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1101X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure",
            "state": "DE",
            "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": "08-03735",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dover AFB MTF",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dover Afb, DE

Sources for this page

  • 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.