Taxonomy Code 1710I1002X(1710i1002x)
Independent Duty Corpsman. Providers: 161

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Independent Duty Corpsman Providers

NPI Name Type Address

1710246061

Vincent Falcetta

Individual

111 C Street

Box 20173

Camp Lejeune, NC

1114273596

MR. IDC Brett Cory Davis

Individual

2d Medical Battalion Psc Box 20129

Charlie Surgical Company

Camp Lejeune, NC

1013264597

Shaun Christopher Dezern

Individual

2d Recon Bn, A-71

Medical Department

Camp Lejeune, NC

1902179898

2d Recon Bn

Organization

2d Marine Division, 2d Recon Bn

Psc Box 20138

Camp Lejeune, NC

1023360856

MR. SOIDC Michael James Elmer I

Individual

2d Recon Bn

Psc Box 20138

Camp Lejeune, NC

1720346745

MR. John Iakopo Leasiolagi

Individual

2d Reconnaissance Bn, 2d Mardiv

Psc Box 20138

Camp Lejeune, NC

1023354586

Petronilo Marcelo JR.

Individual

2nd Medical Battalion Psc Box 20129

Camp Lejeune, NC

1396086252

MR. SOIDC Peter Wren Mcguyer

Individual

2d Reconnaissance Battalion

Psc Box 20138

Camp Lejeune, NC

1194168807

IDC Michael Shane Mitchell

Individual

5371 Washington St

Camp Lejeune, NC

1841636313

MR. IDC George Alan Ladd

Individual

2d Mardiv

Psc Box 2088

Camp Lejeune, NC

1265861322

IDC Christopher Mcintyre

Individual

100 Brewster Blvd

Camp Lejeune, NC

1639597404

IDC Eli Yosaim Hernandez

Individual

6 Marine Regiment Psc Box 20097

Camp Lejeune, NC

1417375809

MR. SOIDC Jeffrey Bentley

Individual

100 Brewster Blvd

Camp Lejeune, NC

1184037004

SARIDC Christopher Dare

Individual

3d Msob

Psc Box 20073

Camp Lejeune, NC

1740698638

Brandon Foisy

Individual

Psc Box 20116

Camp Lejeune, NC

1669750279

IDC Angela Mendez

Individual

Building 327

Camp Lejeune, NC

1487059739

IDC Elizabeth Pell

Individual

100 Brewster Blvd

Camp Lejeune, NC

1215327168

MR. SOIDC Luke Lance Keene

Individual

Marsoc

Psc Box 20073

Camp Lejeune, NC

1487097911

IDC Sharon Leonard

Individual

Bld 316 G Street

Camp Lejeune, NC

1770963548

MR. IDC Christopher J Hunt

Individual

100 Brewster Blvd

Camp Lejeune, NC

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