TERRY DWAYNE SHOULDERS IDC
NPI 1891949616
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Q: What is Terry Shoulders's NPI number?

The NPI number for Terry Shoulders is 1891949616. It was assigned to this individual provider in the NPPES registry on November 6, 2008.

Q: What is Terry Shoulders'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 Terry Shoulders was last updated on November 6, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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 November 06, 2008

3402 TARAWA RD., SPECIAL BOAT TEAM TWELVE MEDICAL DEPARTMENT, SAN DIEGO, CA 92155(619) 437-5540 Get Directions Write a Review

NPPES record last updated: November 6, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Terry Dwayne Shoulders Idc NPPES

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

TERRY DWAYNE SHOULDERS IDC (NPI 1891949616) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since November 2008.

NPPES Registry Identity

NPI1891949616

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameTERRY DWAYNE SHOULDERSCredential: IDC

Location Address3402 TARAWA RD., SPECIAL BOAT TEAM TWELVE MEDICAL DEPARTMENTSan Diego, CA 92155-5003

Mailing Address3375 Gregory StSan Diego, CA 92104-4751 · (760) 668-5569

Phone(619) 437-5540

Sole ProprietorNo

Enumeration DateNovember 6, 2008

✔ NPI 1891949616 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.

3402 TARAWA RD., San Diego, CA 92155

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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 Terry Shoulders's NPI number?

The NPI number for Terry Shoulders is 1891949616. It was assigned to this individual provider in the NPPES registry on November 6, 2008.

Where is Terry Shoulders located?

Terry Shoulders practices at 3402 Tarawa Rd. Special Boat Team Twelve Medical Department, San Diego, CA 92155. The listed phone number is (619) 437-5540.

What is Terry Shoulders'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 Terry Shoulders was last updated on November 6, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.