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

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Independent Duty Corpsman Providers

NPI Name Type Address

1396945705

MR. IDC Benjamin Wade Lambert

Individual

Jwtc Unit 35951

Camp Gonsalves, FPO AP

1053511394

MR. IDC Edward Nmn Goldsborough IV

Individual

3001 A 6th St

Great Lakes, IL

1467652644

IDC Jebin James Ginet

Individual

14900 Park Central Rd

Thurmont, MD

1962692111

MR. IDC Francisco Xavier Eavenson

Individual

2603 Gainesville Road

Stennis Space Center, MS

1972793909

NAVY IDC Brett Staib

Individual

3420 Illinois St

Bhc 1007

Great Lakes, IL

1518157411

MR. Dwight Jabari Ott JR.

Individual

43 Smith Rd

Newport, RI

1770527962

IDC Patrick Blake West

Individual

Uss Louisiana Ssbn 743 (blue)

2100 Thresher Ave

Silverdale, WA

1023143575

IDC Michael S Jimenez

Individual

754 Rambur St

Chula Vista, CA

1427174879

IDC Edward Ervin Moak

Individual

1 West Ave Ste 230

Saratoga Springs, NY

1245420017

Phillip Anthony Rodriguez

Individual

Naval Branch Health Clinic Ingleside

327 Coral Sea Drive, Suite 165

Ingleside, TX

1588854368

MR. IDC Eduardo Malayao Magpayo

Individual

35000 Guadalcanal Ave

San Diego, CA

1891985529

MR. Roy Michael Elias

Individual

327 Coral Sea Rd Suite 123

Ingleside, TX

1760672364

MR. SFIDC Alfonzo L Jacobs

Individual

707 Moss St

Wildwood, FL

1013107499

IDC Mark Anthony Mitchell

Individual

1140 Kellum Loop Rd

#36

Jacksonville, NC

1407046766

MR. IDC Melanio Ayhon Rivera

Individual

Cg Ii Mef

Camp Lejeune, NC

1184838005

MR. I.D.C. Brandon Alan Baker

Individual

Nsa Crane Medical Department Bldg 2516

300 Hwy 361

Crane, IN

1154512457

MR. Joseph Armand Clairmont JR.

Individual

229 Parnell Rd

Hubert, NC

1033300884

MR. NAVY SFIDC Christopher Allen Powell

Individual

14900 Park Central Rd

Thurmont, MD

1417148867

MR. IDC Christian Carl Kerlick JR.

Individual

305 Raintree Cir

Jacksonville, NC

1861684953

MRS. IDC Tia M. Johns

Individual

Us Naval Hospital Naples

Psc 827 Box 217

Fpo, AE

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