Haaris George Bjotvedt, SOIDC (SO-ATP)

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

License

10243398HB Issued in NC

Practice address

2D Marine Raider Battalion
Battalion Aid Station, PSC Box 20183
Camp Lejeune, NC 28542-0183

Phone

(910) 440-7704

NPI assigned

Jul 28, 2025

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1144103292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 RIDGEWAY DR",
            "city": "SNEADS FERRY",
            "state": "NC",
            "postal_code": "284607613",
            "telephone_number": "602-809-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2D MARINE RAIDER BATTALION",
            "address_2": "BATTALION AID STATION, PSC BOX 20183",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420183",
            "telephone_number": "910-440-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BJOTVEDT",
        "first_name": "HAARIS",
        "middle_name": "GEORGE",
        "credential": "SOIDC (SO-ATP)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "NC",
            "license": "10243398HB",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Michael Biagioni
• Sydney Bianca, RD
• Catherine Bianchi, M.ED.
• Joanne Bienaime, DNP, C-PNP-CP
• Matthew Biscotti, M.D.
• Jay A Black, DMD
• Margaret Lillian Black, MD
• Corinne Louise Blanford, LCSW-C
• Ryan Maxwell Blank
• Steven Gerald Blaum, PHD

• Independent Duty Corpsman in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Independent Duty Corpsman in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.