14TH Medgrp-Columbus

Primary specialty

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

Legal business name

14TH MEDGRP-COLUMBUS

Practice address

201 Independence
Suite 101
Columbus, MS 39710-5300

Phone

(662) 434-2159

Fax

(662) 434-2242

NPI assigned

Dec 21, 2005

Last updated

Jun 17, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

14TH MEDGRP-COLUMBUSAs 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

Tax ID family

14TH Medgrp-Columbus2 organizations share this tax ID, including this one

Part of

14TH Medgrp-Columbus

Other organizations with this tax ID 1

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

• 14TH Medgrp-Columbus

  dba DoD COLUMBUS ePhcy

  • Military/U.S. Coast Guard Pharmacy
  • Columbus, MS
  • NPI 1558760504
  NPD tax ID

Locations

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1487630356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 INDEPENDENCE",
            "address_2": "SUITE 101",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397105300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 INDEPENDENCE",
            "address_2": "SUITE 101",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397105300",
            "telephone_number": "662-434-2159",
            "fax_number": "662-434-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "14TH MEDGRP-COLUMBUS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "14TH MEDGRP-COLUMBUS",
        "enumeration_date": "2005-12-21",
        "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": "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": "2520179",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 14TH Medgrp-Columbus (DoD COLUMBUS ePhcy)
• 4D Healthcare, LLC (4D Healthcare)
• Mohamed Abdel Latif, MD
• Jasen Sisson Abraham, DPT
• Whitney Whiteside Abraham, FNP-C

• Military/U.S. Coast Guard Outpatient Clinic/Center in Columbus, MS
• Providers in Columbus, MS by specialty
• Military/U.S. Coast Guard Outpatient Clinic/Center in Mississippi

• 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.