42D MEDGRP-MAXWELL — NPI 1033196878 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in MAXWELL AFB, AL)

CMS-1500 Box 24J / 33a • NPI

1033196878

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QM1100X

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

300 SOUTH TWINING ST, BUILDING 760, MAXWELL AFB, AL, 36112-6219

✓ 9-Digit EDI 837 ZIP+4 (36112-6219)

Practice Phone & Referral Fax

(334) 953-4943

Fax: (334) 953-1741

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1033196878 (42D MEDGRP-MAXWELL) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1033196878` (NPI-2 Organization / Facility)
Provider / Legal Name	42D MEDGRP-MAXWELL
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QM1100X` (Clinic/Center, MilitaryU.S. Coast Guard Outpatient)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	300 SOUTH TWINING ST, BUILDING 760, MAXWELL AFB, AL, 36112-6219
Practice Telephone / Fax	Tel: (334) 953-4943 \| Fax: (334) 953-1741
Administrative Mailing Address	300 SOUTH TWINING ST, MAXWELL AFB, AL, 36112-6219
Enumeration & Last Sync	Enumerated: 2005-12-22 \| CMS Record Updated: 2025-06-16
Authorized Official	JEN LEWANDOWSKI (Defense Health Agency (DHA) Financi)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

300 SOUTH TWINING ST, BUILDING 760, MAXWELL AFB, AL, 36112-6219

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Plain-English Taxonomy & CMS Crosswalk (261QM1100X)

What Does Taxonomy Code 261QM1100X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QM1100X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (42D MEDGRP-MAXWELL)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QM1101X` — Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Secondary
`332000000X` — MilitaryU.S. Coast Guard Pharmacy Plain English: Licensed & Credentialed MilitaryU.S. Coast Guard Pharmacy	State: N/A \| License: `Verified` \| Primary: Secondary
`261QM1100X` — Clinic/Center, MilitaryU.S. Coast Guard Outpatient Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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42D MEDGRP-MAXWELL (NPI #1033196878)