Taxonomy Code 1710I1002X(1710i1002x)
Independent Duty Corpsman. Providers: 297

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Independent Duty Corpsman Providers

NPI Name Type Address

1144616467

Jenna Golding

Individual

3259 Catlin Ave

Quantico, VA

1720437247

MR. IDC Lloyd Reed Hall III

Individual

1814 James Monroe Highway

Colonial Beach, VA

1093137697

Jessica Marie Camblor

Individual

1548 Wilderness Rd

Chesapeake, VA

1144663725

IDC Nicole Ann Wilson

Individual

4701 Apple Tree Dr

Alexandria, VA

1285880484

IDC Jayme Ryan Frianeza

Individual

1808 Shupper Dr

Yorktown, VA

1467630947

SFIDC Jose Omar Vargas

Individual

1840 Gator Blvd

Bldg: 3841

Virginia Beach, VA

1851841449

MR. DIVE IDC John Douglas Moore

Individual

1004 Hermitage Rd Bldg 1014

Virginia Beach, VA

1568904738

Pierce Cogburn

Individual

3985 Old Forge Rd

Virginia Beach, VA

1497298616

Mario Zavala

Individual

408 N Amsterdam Ct

Virginia Beach, VA

1437498870

MR. IDC Michael Benjamin Wachter

Individual

821 Blasters Cv

Virginia Beach, VA

1376637181

MR. IDC Kenneth James Richards

Individual

5265 Riverwood Rd

Norfolk, VA

1972511764

MR. Nathan A. Marsh

Individual

620 John Paul Jones Cir

Portsmouth, VA

1033645403

HM Courtney Osborne

Individual

Uss Abraham Lincoln Cvn 72

Medical Department

Norfolk, VA

1215463104

IDC Markeece Oneale

Individual

13020 Amesbury St

Woodbridge, VA

1316184435

James William Oglesby

Individual

2340 Amphibious Dr Ste 125

Virginia Beach, VA

1366966962

IDC Owen Wilhelm Horton

Individual

472 Polaris St Bldg 586

Virginia Beach, VA

1942719380

MR. SFIDC Clinton James Barton

Individual

1016 Norwyk Ln

Williamsburg, VA

1801307327

IDC Michael Wesley Dixon

Individual

4008 Buchanan Dr

Hampton, VA

1932613718

IDC Scott Lenon

Individual

1465 Hewitt Dr

Virginia Beach, VA

1558877878

IDC Ismael Arturo Lopez

Individual

1721 Admiral Taussig Blvd

Norfolk, VA

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