412th Medgrp-Edwards
412th Medgrp-Edwards is a healthcare organization registered as Military/U.S. Coast Guard Outpatient Clinic/Center in Edwards Afb, CA, holding Type 2 (organization) NPI 1891765046 since 2006. The authorized official on file is Jen Lewandowski, Air Force Ubo Analyst.
✓ Active NPI ✓ Valid NPI checksum Organization subpart
| NPI | 1891765046 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | 412th Medgrp-Edwards |
| Parent organization | 412th Medgrp-Edwards |
| Practice address | 30 NIGHTINGALE RD, BLDG 5525, Edwards Afb, CA, 93524 |
| Phone | 6612752634 |
| Fax | 6612776645 |
| Enumeration date | 2006-01-23 |
| Last updated in NPPES | 2025-06-16 |
Authorized official
| Name | Jen Lewandowski |
|---|---|
| Title | Air Force Ubo Analyst |
| Phone | 7038174030 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QM1101X | Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center | Secondary | — | — |
| 332000000X | Military/U.S. Coast Guard Pharmacy | Secondary | — | — |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05-40345 | Other | CA | NCPDP |
Copy-ready billing details
Provider: 412th Medgrp-Edwards NPI: 1891765046 Taxonomy: 261QM1100X (Military/U.S. Coast Guard Outpatient Clinic/Center) Address: 30 NIGHTINGALE RD, BLDG 5525, Edwards Afb, CA, 93524
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1902952880 | Jerel Scarberry | Individual | Pediatrics Physician | Edwards Afb, CA |
| 1962612762 | Tracy Neal-Walden | Individual | Health Psychologist | Edwards, CA |
| 1710186135 | Richard Baird | Individual | Optometrist | Edwards Afb, CA |
| 1174722425 | Mary Carnduff | Individual | Orthopaedic Surgery Physician | Edwards, CA |
| 1780958645 | Shunrie Geldore | Individual | Physician Assistant | Edwards Afb, CA |
| 1437493806 | Scott Baker | Individual | Pharmacist | Edwards Afb, CA |
| 1184062101 | Piotr Podlesny | Individual | Family Medicine Physician | Edwards Afb, CA |
| 1538585872 | Josephine Nguyen | Individual | Dentist | Edwards Afb, CA |
Verify this record
Cross-check NPI 1891765046 against the authoritative CMS record: view 412th Medgrp-Edwards on the official NPPES registry .
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 or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is 412th Medgrp-Edwards?
Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2025-06-16.