Taxonomy Code 1710I1002X(1710i1002x)
Independent Duty Corpsman. Providers: 157

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Independent Duty Corpsman Providers

NPI Name Type Address

1073066577

IDC Zachary Jay Camechis

Individual

177 Hornbeam Rd

Groton, CT

1891248308

IDC Kenneth Aloka Waugh

Individual

151 Burningtree Dr

Groton, CT

1881147395

Kennedy Onditi

Individual

8 Deerwood Dr

Groton, CT

1508319955

IDC Christine Moore

Individual

200 Michelle Ln Apt 310

Groton, CT

1528512175

MR. IDC Adam Sigurd Larson

Individual

158 Hawthorne Dr

17d

New London, CT

1952858482

IDC Prudencio Cupat Sy

Individual

Bldg 159 Navsubase Nlon

Naval Undersea Medical Institute

Groton, CT

1962959478

United States Navy

Organization

1 Crystal Lake Rd

Bldg 159 Naval Undersea Medical Inst. Navsubase Nlon

Groton, CT

1922551266

Kevin Bradley

Individual

1 Wahoo Ave

Groton, CT

1942745732

IDC Nicholas Mihalecz

Individual

2 Cole St

Groton, CT

1104361997

IDC Jean Paul Dennis Vargas

Individual

96 Michael Rd Apt F

New London, CT

1508301300

Kevin M Harding

Individual

193 Charter Oak Dr

Groton, CT

1700321510

Matthew Thompson

Individual

58 Hornbeam Rd

Groton, CT

1184160483

MR. IDC Michael Dean Couch

Individual

159 Trout Ave

Groton, CT

1992241228

IDC Phillip Lawernce Hardy SR.

Individual

123 Trout Ave

Naval Undersea Medical Institiute

Groton, CT

1891229472

MR. IDC Nicholas Manjarrez

Individual

159 Trout Avenue

Naval Undersea Medical Institute

Groton, CT

1932622230

IDC Anthony J Gervasi

Individual

159 Trout Ave

Groton, CT

1750804050

Adam S Green

Individual

159 Trout Ave

Groton, CT

1396268595

IDC Andrew Azevedo

Individual

159 Trout Ave

Groton, CT

1205359494

IDC Joseph Lampert

Individual

159 Trout Ave

Groton, CT

1790208882

MR. George Charles Fricke

Individual

159 Trout Ave

Groton, CT

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