MATTHEW DEFRIES L02A
NPI 1710512009
Military Health Care Provider - Independent Duty Corpsman in Virginia Beach, VA

Q: What is Matthew Defries's NPI number?

The NPI number for Matthew Defries is 1710512009. It was assigned to this individual provider in the NPPES registry on March 6, 2020.

Q: What is Matthew Defries'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 Matthew Defries was last updated on June 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 March 06, 2020

472 POLARIS ST BLDG 586, VIRGINIA BEACH, VA 23461(219) 869-1039 Get Directions Write a Review

NPPES record last updated: June 22, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jun 22, 2023, Mar 6, 2020 (2 updates tracked since 2020).

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About Matthew Defries L02a NPPES

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

MATTHEW DEFRIES L02A (NPI 1710512009) is an individual independent duty corpsman provider in Virginia Beach, Virginia, licensed in Indiana (5060000751) and active in the NPI registry since March 2020.

NPPES Registry Identity

NPI1710512009

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameMATTHEW DEFRIESCredential: L02A

Location Address472 POLARIS ST BLDG 586Virginia Beach, VA 23461-1935

Mailing Address472 Polaris St Bldg 586Virginia Beach, VA 23461-1935

Phone(219) 869-1039

Sole ProprietorNo

Enumeration DateMarch 6, 2020

Last NPPES UpdateJune 22, 20232 updates tracked since enumeration

NPPES CertifiedJune 22, 2023

✔ NPI 1710512009 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

License✔ Licensed in IN · 5060000751

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.

472 POLARIS ST BLDG 586, Virginia Beach, VA 23461

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Other Providers at the Same Location NPPES 13

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

LAURA KATHLEEN CARGILL PA-C

Physician Assistant (Medical)