Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum Organization subpart

366th Medgrp-Mountain Home

Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center in Mountain Home Afb, ID · enumerated 2006 · authorized official Jen Lewandowski, Dha Ubo.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1063487791

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Registry record

Entity type Organization (Type 2)

Legal business name 366th Medgrp-Mountain Home

Parent organization 366th Medgrp-Mountain Home

Practice address 90 Hope Drive Bldg 6000, 366 Medical Group, Mountain Home Afb, ID, 83648

Phone (208) 828-7470

Fax (208) 828-2753

Enumeration date Feb 17, 2006

Last updated in NPPES Jun 17, 2025

Taxonomy & classification

261QM1100X Military/U.S. Coast Guard Outpatient Clinic/Center Ambulatory Health Care Facilities Secondary

261QM1101X Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center Ambulatory Health Care Facilities Primary

332000000X Military/U.S. Coast Guard Pharmacy Suppliers Secondary

Authorized official

Name Jen Lewandowski

Title Dha Ubo

Phone (703) 817-4030

Other identifiers

Identifier	Type	State	Issuer
8072078	Medicaid	ID	-
1306845	Other	ID	NCPDP

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2025-06-17. Verify at npiregistry.cms.hhs.gov.

Where is 366th Medgrp-Mountain Home located?

The practice location on file with NPPES is in Mountain Home Afb, ID.

Providers at this address

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Dandy Aaron Independent Duty Medical Technicians · Mountain Home, ID NPI 1093943870 Kathleen Lacasse Independent Duty Medical Technicians · Mountian Home Afb, ID NPI 1538802830

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-06-17.