633D Medgrp-JB Langley

Primary specialty

Military and U.S. Coast Guard Ambulatory Procedure Clinic/CenterTaxonomy code 261QM1101X

Legal business name

633D MEDGRP-JB LANGLEY

Practice address

77 Nealy Ave
Langley AFB, VA 23665-2040

Phone

(757) 764-6807

Fax

(757) 764-0821

NPI assigned

Nov 22, 2005

Organization subpart

Yes

Parent organization

633D MEDGRP-JB LANGLEYAs 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 Financial Manager

Phone

(703) 817-4030

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• 1st Medical Group Former legal business name

Tax ID family

633D Medgrp-JB Langley2 organizations share this tax ID, including this one

Part of

633D Medgrp-JB Langley

Other organizations with this tax ID 1

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

• 633D Medgrp-JB Langley

  dba Dod Langley Pharmacy

  • Military/U.S. Coast Guard Pharmacy
  • Hampton, VA
  • NPI 1720494834
  NPD tax ID

Locations

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1609859891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 NEALY AVE",
            "city": "LANGLEY AFB",
            "state": "VA",
            "postal_code": "236652040",
            "telephone_number": "757-764-6807",
            "fax_number": "757-764-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 NEALY AVE",
            "city": "LANGLEY AFB",
            "state": "VA",
            "postal_code": "236652040",
            "telephone_number": "757-764-6807",
            "fax_number": "757-764-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "633D MEDGRP-JB LANGLEY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "633D MEDGRP-JB LANGLEY",
        "enumeration_date": "2005-11-22",
        "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 FINANCIAL MANAGER",
        "authorized_official_telephone_number": "703-817-4030"
    },
    "taxonomies": [
        {
            "code": "261QM1101X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4834722",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000686",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "1st Medical Group",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "1st Medical Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Ashley Nicole Abbott, IDMT
• Aaron Alvarez, IDMT
• Gregory Anderson
• Alexis Antequera, MD
• Jennifer Marie Arnold, DNP, RN

• Clinic/Center in Langley AFB, VA
• Providers in Langley AFB, VA by specialty
• Clinic/Center in Virginia

• 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.