Taxonomy Code 1710I1002X(1710i1002x)
Independent Duty Corpsman. Providers: 3,002

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Independent Duty Corpsman Providers

NPI Name Type Address

1255589784

MR. IDC John Charles Averell

Individual

Naval Medical Center San Diego

Bldg 14

Apo, AP

1164671640

MR. IDC USN Jason Zane Dillow

Individual

Patrol Coastal Crew Mike

Pc 2

Fpo, AE

1881843084

MR. HMC Mark Francis Jarvis

Individual

Nssc Nlon

Bldg 76

Groton, CT

1831348838

MR. IDC Sean Gregory Pearson

Individual

2600 Tarawa Ct Ste 260

Norfolk, VA

1831385749

MR. IDC Timothy Douglas Bork

Individual

Psc 836 Box 512

Fpo, AE

1528238680

Patrick Michael Wiens

Individual

1745 10th St

Norfolk, VA

1497904387

US NAVY IDC Douglas A Mullen

Individual

Uss Iwo Jima (lhd7)

Medical Department

Fpo, AE

1003065913

MR. Kelvin Ladon Harris

Individual

Uss Tennessee (ssbn 734)

Fpo, AP

1053560995

MR. IDC Thomas Carter Randolph

Individual

Uss Elrod Ffg 55

Fpo, AE

1922257724

IDC Mark Allan Delay

Individual

1875 Cove Rd

Bldg 3806

Norfolk, VA

1215186861

IDC Jeremy Richard Schlotterer

Individual

Uss Typhoon Pc-5

Fpo, AE

1235194135

IDC Gordon Arthur Smith

Individual

Uss Helena Ssn 725

Apo-ap, CA

1578592838

SUBMARINE IDC Eric Windsor Larson SR.

Individual

580 Uss Mariano G Vallejo Ave

Nssc Medical Kings Bay

Kings Bay, GA

1932359395

IDC Kerry Lee Barnett

Individual

Psc 827 Box 33

Fpo, AE

1326298795

SFIDC Greg Allan Lassiter

Individual

3110 B Seagull St

Gulfport, MS

1487804878

MR. INDEPENDENT DUTY COR Francis Lalisan Arcilla

Individual

Psc 561

Box 3303

Fpo, AP

1730339763

IDC Toby Natividad Hernandez

Individual

Mwtc Bldg 3005 State Route 108

Attn: Medical

Bridgeport, CA

1407006331

Jennifer Lynn Myers

Individual

140 Sylvester Rd

San Diego, CA

1245480185

MR. IDC Randall Victor Johnson

Individual

Uss West Virginia (ssbn 736) (blue)

Fpo, AA

1316197056

MR. IDC Gary Cherry JR.

Individual

35000 Guadalcanal St

Branch Medical Clinic Mcrd

San Diego, CA

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