Taxonomy Code 1710I1002X(1710i1002x)
Independent Duty Corpsman. Providers: 35

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Independent Duty Corpsman Providers

NPI Name Type Address

1093097891

Aaron Isaiah Castro

Individual

409 South Bluff Circle

Jacksonville, NC

1033475496

MR. IDC Roy Antoine Teague JR.

Individual

807 Springwood Dr

Jacksonville, NC

1659638773

MR. IDC Othea C, Williams

Individual

285 Brookstone Way

Jacksonville, NC

1407113111

MRS. IDC Jessica Lea Petty

Individual

194 Maready Rd

Jacksonville, NC

1104175157

Nicholas Arlo Villasana

Individual

403 Huff Dr

Jacksonville, NC

1134565609

IDC William Everett Peters

Individual

102 Lennox Circle

Jacksonville, NC

1548660988

Brandon Rupe

Individual

512 Delaney Dr

Jacksonville, NC

1205206711

MR. SFIDC Robert Dotter

Individual

Bldg Fc308

Jacksonville, NC

1285179077

MR. Bill Lee Todd Davis

Individual

1151 Murrill Hill Rd

Jacksonville, NC

1174043244

Jason Waters

Individual

White St

Bldg As-100

Jacksonville, NC

1497176846

IDC Anthony Tomassini

Individual

103 Fieldgate Dr

Jacksonville, NC

1316584543

MRS. IDC Christina Koch

Individual

104 Eagle River Ct

Jacksonville, NC

1003238734

SFIDC Erica Lynn Ann Reiter

Individual

803 Oleander St

Jacksonville, NC

1639793748

IDC Johnathon T Brewer

Individual

100 White St

Jacksonville, NC

1386315695

MILITARY PROVIDER Garrett Clyde Ballo

Individual

116 Moss Creek Dr

Jacksonville, 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