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

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Independent Duty Corpsman Providers

NPI Name Type Address

1689896995

MR. IDC Matthew James Schaffer

Individual

34101 Farenholt Ave

San Diego, CA

1871705673

SUBMARINE IDC Christopher Lee Drennon

Individual

Mcsfco Bangor

Silverdlae, WA

1558576702

MR. IDC Kevin Richard Mattos

Individual

Marvin Shields Blvd

Cbc Gulfport

Gulfport, MS

1255543930

IDC David Partible Carbungco

Individual

Naval Hospital Camp Pendleton

Box 555191-5191

Camp Pendleton,, CA

1164635520

MR. IDC Shannon Patrick Johnson

Individual

1004 Hermitage Rd

Bldg 2052

Norfolk, VA

1588879779

MR. IDC Ralph Allen Rowe JR.

Individual

Mobile Security Squadron Six

Nnsy Bld 15

Portsmouth, VA

1760695431

MR. IDC Corey J Seymour

Individual

4837 Mccall Ln

Panama City, FL

1073725701

MR. IDC James Payne

Individual

1956c Gillespie Cir

Honolulu, HI

1831302074

MR. IDC Alex Alfredo Duranalvarado SR.

Individual

300 Centerton Rd

Moorestown, NJ

1023222585

MR. IDC Jason L Coambes

Individual

6292 East 43rd Street

Yuma, AZ

1346454808

MR. OTHER Joseph Thomas Minich

Individual

2410 Sampson St Bldg 237

Great Lakes, IL

1164637005

MR. IDC, RN Preston P. Thrift

Individual

53560 Hull St

San Diego, CA

1477766871

MR. IDC Michael Robert Grohman

Individual

41256 Stewart Mesa Rd

Camp Pendleton, CA

1235341645

MR. SFIDC Scott A Spence

Individual

Uss Benfold (ddg 65)

Medical Department

Fpo, US NAVY

1619189198

MR. IDC Joseph Lionel Rivas SR.

Individual

2080 Child St

Jacksonville, FL

1932312097

MR. HM IDC Scott David Graham

Individual

Eodmu 5 Unit 25499

2112 Sumay Cove Drive

Santa Rita, GAUM

1568675528

MR. Michael Francis Mccune

Individual

34101 Farenholt Ave.idc Suite

San Diego, CA

1609080589

IDC Luis Alexander Glinton

Individual

Norfolk Naval Shipyard

Bldg 15

Portsmouth, VA

1700090685

MR. IDC Ronald Derald Fryar JR.

Individual

1451 Lexington Drive

Ingleside, TX

1063627099

MS. IDC Connie Jean Lawson

Individual

34101 Farenholt Ave Bldg 14

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