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

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Independent Duty Corpsman Providers

NPI Name Type Address

1720266422

SFIDC Jesse R Bedia

Individual

1400 Otterbourne Cir

Chesapeake, VA

1588842298

MR. I.D.C. Sean V Gutierrez

Individual

100 Brewster Ave

Camp Lejeune, NC

1922068246

MR. Chaddrick Lendon Jack

Individual

10651 E St

Corpus Christi, TX

1255519773

MRS. Osvaldo Diaz

Individual

3d Battalion 1st Mar Battalion Aid Station

Box 555422

Camp Pendleton, CA

1144408501

IDC Matthew David Hall

Individual

1 Pinckney Blvd

Beaufort, SC

1730367020

Alexander Joseph Mabile III

Individual

5722 Integrity Dr

Navmac

Millington, TN

1780882738

IDC Michael Nutt

Individual

Bldg 517 Taugtog Ave

Navsubscol

Groton, CT

1134397920

MR. IDC Peter Robert Rona

Individual

Bldg 4389 Beaufort Rd

Naval Health Clinic

Cherry Point, NC

1407067259

MR. IDC Michael Bohdan Bozydaj

Individual

14900 Park Central

Thurmont, MD

1487723532

MR. IDC Karl Frederic Matous

Individual

Msron 9 Naval Station Everett

2000 Marine View Drive Building 2134

Everett, WA

1417126749

IDC Damon Anderson

Individual

108 Brentwood Cir

Virginia Beach, VA

1568631539

NAVY IDC Juan Carlos Vazquez

Individual

3936 Baja Vista Dr

Oceanside, CA

1568631018

MR. I.D.C Christopher James Bray

Individual

Psc Box 8023 Bldg 8029 Beaufort Rd

Naval Health Clinic Cherry Point

Cherry Point, NC

1255500609

MR. Jesse John Tossetti

Individual

6591 49 Palms Ave

Twentynine Palms, CA

1386814697

MR. IDC Travis James Harmon

Individual

1550 Tomcat Blvd

Virginia Beach, VA

1902076219

MRS. IDC Pamela Jeanne Arceneaux

Individual

1035 Nider Blvd

Suite 100

Norfolk, VA

1710157029

MS. Anita Dalton

Individual

554 Loch Ness Dr Apt E

Newport News

Newport News, VA

1275502551

MR. Christopher Lee Brey

Individual

Bureau Of Medicine And Surgery

2300 E Street, Nw

Washington, DC

1689782294

I.D.C. Carlos Roberto Martinez

Individual

161 1st St

Bldg 1402

Port Hueneme, CA

1477521458

MR. Edward Vincent Kay

Individual

881 Uss James Madison Rd

Kings Bay, GA

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