MR. MARK HALEY JOHNSON IDC
NPI 1710199666
Military Health Care Provider - Independent Duty Corpsman in Groton, CT

Q: What is Mark Johnson's NPI number?

The NPI number for Mark Johnson is 1710199666. It was assigned to this individual provider in the NPPES registry on May 4, 2007.

Q: What is Mark 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 Mark Johnson was last updated on May 6, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 May 04, 2007

NLON MEDICAL DEPARTMENT BLDG 76, NAVAL SUBMARINE BASE, GROTON, CT 06340(860) 694-2795(860) 694-4326 Get Directions Write a Review

NPPES record last updated: May 6, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Mark Haley Johnson Idc NPPES

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

MR. MARK HALEY JOHNSON IDC (NPI 1710199666) is an individual independent duty corpsman provider in Groton, Connecticut and active in the NPI registry since May 2007.

NPPES Registry Identity

NPI1710199666

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameMR. MARK HALEY JOHNSONCredential: IDC

Location AddressNLON MEDICAL DEPARTMENT BLDG 76, NAVAL SUBMARINE BASEGroton, CT 06340

Mailing Address197 Charter Oak DrGroton, CT 06340 · (860) 865-0297

Phone(860) 694-2795

Fax(860) 694-4326

Sole ProprietorNo

Enumeration DateMay 4, 2007

Last NPPES UpdateMay 6, 2011

✔ NPI 1710199666 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.

NLON MEDICAL DEPARTMENT BLDG 76, Groton, CT 06340

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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 Mark Johnson's NPI number?

The NPI number for Mark Johnson is 1710199666. It was assigned to this individual provider in the NPPES registry on May 4, 2007.

Where is Mark Johnson located?

Mark Johnson practices at Nlon Medical Department Bldg 76 Naval Submarine Base, Groton, CT 06340. The listed phone number is (860) 694-2795.

What is Mark 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 Mark Johnson was last updated on May 6, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.