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

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Independent Duty Corpsman Providers

NPI Name Type Address

1487830352

MR. Stephen Michael Ito

Individual

100 Brewster Blvd

Camp Lejeune, NC

1629033907

MR. Morrell J Lavender

Individual

2650 Stockton Rd Bldg 624

Naval Training Center

San Diego, CA

1205012028

MR. I.D.C. Jeremy Lee Simon

Individual

100 Brewster Blvd

Camp Lejeune, NC

1700062593

SFIDC Jason Schwieterman

Individual

2200 Scorpion Ave

Silverdale, WA

1508042391

IDC Scott David Egdorf

Individual

100 Brewster Blvd

Camp Lejeune, NC

1982880589

John Ray Lafferty

Individual

100 Brewster Blvd

Camp Lejeune, NC

1003092610

MRS. Nikki G Sims

Individual

1219 Las Cruces Dr

Winter Springs, FL

1811173446

MRS. Rachael Naomi Bradley

Individual

100 Brewster Blvd

Camp Lejeune, NC

1619153285

IDC Daniel Curtis Roberts

Individual

159 Trout Ave

Groton, CT

1952587222

SUB IDC Dmaurier Barnhart

Individual

881 Uss James Madison Rd

Kings Bay, GA

1144406265

HS, USCG Mark A. Strange

Individual

1222 Spruce St

Room 2-102a

Saint Louis, MO

1497931448

Rodney A. Layton

Individual

100 Brewster Blvd

Camp Lejeune, NC

1851504237

MR. IDC Dean Natale Del Favero

Individual

2008 Stump Neck Rd

Indian Head, MD

1760668792

MR. Mark Mammoth

Individual

1 Wahoo Drive

Naval Branch Health Clinic

Groton, CT

1609053610

MR. Karl Frederick Schriever

Individual

1 Wahoo Drive

Naval Branch Health Clinic

Groton, CT

1427235324

Chad Jeremy Nelson

Individual

100 Brewster Blvd

Camp Lejeune, NC

1720265101

MR. William Eickhoff

Individual

650 Sewall Street

Naval Branch Health Clinic

Brunswick, ME

1427235803

Travis Daniel Miller

Individual

1078 Hospital Rd

Fort Story, VA

1174738793

MR. IDC Mark Allen Taylor

Individual

5905 34th Ave S

Minneapolis, MN

1376751917

Michael Clark

Individual

140 Sylvester Rd

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