Individual provider Active NPI

Kendall Pick, SOIDC

  • Independent Duty Corpsman
  • Camp Lejeune, NC
National Provider Identifier
1285343285
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
BLDG a 71 Sneads Ferry Rd
Camp Lejeune, NC 28542
Phone
(910) 440-7703
NPI assigned
Nov 17, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X NC Primary

Addresses

Primary practice location

BLDG a 71 Sneads Ferry Rd
Camp Lejeune, NC 28542

Mailing address

Camp Lejeune
PSC Box 20138
Camp Lejeune, NC 28542
Phone (910) 440-7703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1285343285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CAMP LEJEUNE",
            "address_2": "PSC BOX 20138",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "28542",
            "telephone_number": "910-440-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG A 71 SNEADS FERRY RD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "28542",
            "telephone_number": "910-440-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICK",
        "first_name": "KENDALL",
        "credential": "SOIDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Lejeune, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.