355TH MEDGRP-DAVIS-MONTHAN
NPI 1245210384
Clinic/Center - Military/U.S. Coast Guard Outpatient in Tucson, AZ

NPI Status: Active since January 17, 2006

Contact Information

4175 S ALAMO AVE
TUCSON, AZ
ZIP 85707
Phone: (520) 228-1506
Fax: (520) 228-0183

Get Directions Reviews

  • Organization
  • Clinic/Center
  • Military/U.S. Coast Guard Outpatient

About 355TH MEDGRP-DAVIS-MONTHAN

This page provides the complete NPI Profile along with additional information for 355th Medgrp-davis-monthan, a provider established in Tucson, Arizona operating as a Clinic/center, focusing in military/u.s. coast guard outpatient . The healthcare provider is registered in the NPI registry with number 1245210384 assigned on January 2006. The practitioner's primary taxonomy code is 261QM1100X. The provider is registered as an organization and their NPI record was last updated June 2025. The authorized official of this NPI record is Jen Lewandowski (Air Force Uniform Business Office)

NPI
1245210384
Provider Name
355TH MEDGRP-DAVIS-MONTHAN
Entity Type
Organization
Location Address
4175 S ALAMO AVE TUCSON, AZ 85707
Location Phone
(520) 228-1506
Location Fax
(520) 228-0183
Mailing Address
4175 S ALAMO AVE TUCSON, AZ 85707
Mailing Phone
(520) 228-1506
Mailing Fax
(520) 228-0183
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
01-17-2006
Last Update Date
06-16-2025
Code Navigator

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Military/U.S. Coast Guard Outpatient

Taxonomy Code
261QM1100X
Type
Ambulatory Health Care Facilities
Taxonomy Description
The Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1261QM1101XAmbulatory Health Care Facilities

Clinic/Center
Military and U.S. Coast Guard Ambulatory Procedure

 
2332000000XSuppliers

Military/U.S. Coast Guard Pharmacy

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JEN LEWANDOWSKI

Authorized Official Title
AIR FORCE UNIFORM BUSINESS OFFICE
Authorized Official Phone
(703) 817-4030

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
0322103OTHER (01)AZNCPDP

Reviews for 355TH MEDGRP-DAVIS-MONTHAN

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1245210384
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2285410316
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 8 + 5 + 4 + 1 + 0 + 3 + 1 + 6 + 24 = 56
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 56 = 44

The NPI number 1245210384 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1821083536MS. SANDRA KAY KUHN WHNP
Individual
Nurse Practitioner (Women's Health)4175 S ALAMO AVE BLDG 400
DAVIS MONTHAN AFB, AZ 85707
(520) 228-2665
1134110174MS. ALTHEA B MILLER
Individual
Advanced Practice Midwife4175 S ALAMO AVE DAVIS-MONTHAN AFB
TUCSON, AZ 85707
(520) 228-2615
1225012321DR. GARY LEE HURWITZ M.D.
Individual
Emergency Medicine4175 S ALAMO AVE
TUCSON, AZ 85707
(520) 228-2719
1538146972 SHANNEN MARIE WRIGHT NURSE PRACTITIONER
Individual
Nurse Practitioner (Women's Health)4175 S ALAMO AVE
DAVIS MONTHAN AFB, AZ 85707
(520) 228-2665
1982682514DR. ROBIN L LIVINGSTON DMD
Individual
Dentist (General Practice)4175 S ALAMO AVE
DAVIS MONTHAN AFB, AZ 85707
(520) 228-1911
1952389223DR. HOWARD ROBERT ZVEITEL D.O.
Individual
Family Medicine4175 S ALAMO AVE 355TH MEDICAL GROUP
TUCSON, AZ 85707
(520) 228-2810
1851371686 CRAIG ALAN WARDELL M.D.
Individual
Family Medicine4175 S ALAMO AVE
DAVIS MONTHAN A F B, AZ 85707
(520) 228-1593
1346220860MR. TROY JOHN SELBY PA-C
Individual
Physician Assistant4175 S ALAMO AVE
DM AFB, AZ 85707
(520) 228-1593
1063492502DR. CARL WAYNE DASSE MD
Individual
Family Medicine4175 S ALAMO AVE
DM AFB, AZ 85707
(520) 228-2600
1619947868DR. ROOSEVELT ALLEN DDS
Individual
Dentist4175 S ALAMO AVE
DAVIS MONTHAN A F B, AZ 85707
(520) 228-2654
1063482255DR. ALLAN CURTISS BUSHNELL JR. MD, MSPH
Individual
Preventive Medicine (Preventive Medicine/Occupational Environmental Medicine)4175 S ALAMO AVE DAVIS-MONTHAN AIR FORCE BASE
TUCSON, AZ 85707
(520) 228-2720
1881664076MRS. KIMBERLEY K. PROCKELO RDH
Individual
Dental Hygienist4175 S ALAMO AVE
DM AFB, AZ 85707
(520) 228-2651
1033184551 NANCY CHRISTY N.P.
Individual
Nurse Practitioner (Women's Health)4175 S ALAMO AVE BUILDING 400
DM AFB, AZ 85707
(520) 228-2665
1841251733 KENNETH LEE SANDOCK M.D.
Individual
Specialist4175 S ALAMO AVE
TUCSON, AZ 85707
(520) 228-2870
1104860873MS. CINDI A GOLD PT, SCS
Individual
Physical Therapist4175 S ALAMO AVE
TUCSON, AZ 85707
(520) 228-2886
1467488478DR. WILLIAM EDWARD CROOKS D.M.D.
Individual
Dentist (Periodontics)4175 S ALAMO AVE
DAVIS MONTHAN A F B, AZ 85707
(520) 228-2651
1700957420 VIRGINIA ANN UNDERWOOD M.D.
Individual
Family Medicine4175 S ALAMO AVE
DAVIS MONTHAN AFB, AZ 85707
(520) 228-2600
1841366267DR. BASSAM M FAKHOURI M.D.
Individual
Pediatrics4175 S ALAMO AVE DAVIS-MONTHAN AFB
TUCSON, AZ 85707
(520) 228-2600
1205987039 PETRAN BEARD
Individual
Family Medicine4175 S ALAMO AVE DAVIS-MONTHAN AFB
TUCSON, AZ 85707
(520) 228-2719
1699963843 ANGELA UNDINE JOSIAH PHARMD
Individual
Pharmacist4175 S ALAMO AVE PHARMACY
TUCSON, AZ 85707
(520) 228-1923

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1245210384, enumerated in the NPI registry as an "organization" on January 17, 2006

The provider is located at 4175 S Alamo Ave Tucson, Az 85707 and the phone number is (520) 228-1506

This medical organization specializes in Clinic/Center with taxonomy code 261QM1100X with a focus in Military/U.S. Coast Guard Outpatient

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on January 17, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.