JEDIDIAH E. JOHNSON HS1, IDC
NPI 1114000130
Military Health Care Provider - Independent Duty Corpsman in Homer, AK

Q: What is Jedidiah Johnson's NPI number?

The NPI number for Jedidiah Johnson is 1114000130. It was assigned to this individual provider in the NPPES registry on October 23, 2006.

Q: What is Jedidiah Johnson's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

Q: When was this NPI record last updated?

The NPPES record for Jedidiah Johnson was last updated on October 8, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 23, 2006

4688 HOMER SPIT RD, HOMER, AK 99603(360) 567-8238 Get Directions Write a Review

NPPES record last updated: October 8, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jedidiah E. Johnson Hs1, Idc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEDIDIAH E. JOHNSON HS1, IDC (NPI 1114000130) is an individual independent duty corpsman provider in Homer, Alaska and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1114000130

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameJEDIDIAH E. JOHNSONCredential: HS1, IDC

Location Address4688 HOMER SPIT RDHomer, AK 99603-8001

Mailing Address4688 Homer Spit Rd, Uscgc HickoryHomer, AK 99603 · (360) 567-8238

Phone(360) 567-8238

Sole ProprietorNo

Enumeration DateOctober 23, 2006

Last NPPES UpdateOctober 8, 2013

✔ NPI 1114000130 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers

Taxonomy Code1710I1002X

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.

Also ListedTechnician, OtherTaxonomy 247200000X

4688 HOMER SPIT RD, Homer, AK 99603

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRIAN MAKSIN HS

Technician, Other

4688 HOMER SPIT RD, MEDICAL
HOMER, AK 99603

Kenai Peninsula Borough (907) 235-5233

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jedidiah Johnson's NPI number?

The NPI number for Jedidiah Johnson is 1114000130. It was assigned to this individual provider in the NPPES registry on October 23, 2006.

Where is Jedidiah Johnson located?

Jedidiah Johnson practices at 4688 Homer Spit Rd, Homer, AK 99603. The listed phone number is (360) 567-8238.

What is Jedidiah Johnson's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Jedidiah Johnson was last updated on October 8, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.