Taxonomy Code 1710I1002X(1710i1002x)
Independent Duty Corpsman. Providers: 29

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Independent Duty Corpsman Providers

NPI Name Type Address

1932566130

DIVE IDC Virgil Allen Newton

Individual

4643 Dock Rd Bldg 524

Port Hueneme, CA

1467798900

I.D.C Andrew Tyson Hammond

Individual

162 1st St

Port Hueneme, CA

1629592605

IDC Andrew Guilmond Nadeau

Individual

1183 North Ventura Road

Port Hueneme, CA

1265951305

IDC Nickolas Vincent Ponce

Individual

162 1st St Bldg 1402

Port Hueneme, CA

1558852921

Ryan Kitchens

Individual

4643 Dock Road Building 524

Port Hueneme, CA

1275007791

Shayne Tyler Stanley

Individual

2600 Dodson St Ste 3

Port Hueneme, CA

1144867532

MR. IDC Andrew Thanh Bui

Individual

162 1st St

Port Hueneme, CA

1831702950

IDC Kyle Leonard Gosselin

Individual

2600 Dodson St Ste 3

Port Hueneme, CA

1578227609

IDC Ryan Michael Hembree

Individual

Nav Mob Const Batt 5

2600 Dodson St Ste 3

Port Hueneme, CA

How to obtain, renew, or terminate an NPI

Every health care provider, whether it’s a hospital, pharmacy, or individual specialist, must obtain their own NPI number. This identification number is unique and is assigned upon application. In tod...

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Taxonomy Code 1710I1002X
Specialization Independent Duty Corpsman
Display Name Independent Duty Corpsman
Taxonomy Group Other Service Providers
Taxonomy Classification Military Health Care Provider
Definition A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Effective Date September 30, 2009
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Military Health Care Provider Codes

Independent Duty Medical Technicians

1710I1003X • providers: 1,299

Military Health Care Provider

171000000X • providers: 1,689