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

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Independent Duty Corpsman Providers

NPI Name Type Address

1669644126

MR. IDC Edward Austin Magrill

Individual

620 John Paul Jones Cir

Portsmouth, VA

1174109540

Nicholas David Becker

Individual

4101 Washington Ave

Newport News, VA

1841635836

IDC Paul Q Brown

Individual

618 4th St

Williamsburg, VA

1710560636

MR. SOIDC, ATP, FPC Anson Thomas Rice

Individual

Nswdg 402 Polaris Street

Bldg 586

Virginia Beach, VA

1740857994

David Collmus

Individual

3555 Montgomery Ln

Charlottesville, VA

1285872457

MR. PA-C Timothy Aaron Gundlach

Individual

1936 Tibbetstown Dr

Virginia Beach, VA

1457022998

Mark Edward Logan

Individual

3823 Main St

Chincoteague, VA

1083385272

MILITARY HEALTH CARE Sarah Cielecki

Individual

1260 Shotgun Rd

Chesapeake, VA

1407527583

IDC Scott Lee Meyer

Individual

4000 Coast Guard Blvd

Portsmouth, VA

1780356881

Jo-davy Andre Jauregui

Individual

4000 Coast Guard Blvd

Portsmouth, VA

1669134193

IDHS Michael Thomas Miozzi

Individual

Base Portsmouth Portsmouth

4000 Coast Guard Blvd

Portsmouth, VA

1588326904

MR. USCG IDHS David Andrew Debose

Individual

1260 Shotgun Rd

Chesapeake, VA

1881358851

IDHS Anatoliy Olexandrovych Gryshchenko

Individual

4000 Coast Guard Blvd

Portsmouth, VA

1689338469

MR. William Jessie Cantrell

Individual

Uscgc Spencer, Wmec-905

4000 Coast Guard Blvd.

Portsmouth, VA

1265401673

MR. SUB IDC Randy Scott Breidel

Individual

Dam Neck Annex

1885 Terrier Ave Ste 100

Virginia Beach, VA

1912435819

IDC Katrina Morato

Individual

408 N Amsterdam Ct

Virginia Beach, VA

1205356433

MR. Nicholas Aaron Kilgore

Individual

472 Polaris St Bldg 586

Virginia Beach, 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