Andrew Sieber, SOIDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

304 Sea Hunter Way
Sneads Ferry, NC 28460-6012

Phone

(860) 462-2636

NPI assigned

Sep 30, 2019

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1669013785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 SEA HUNTER WAY",
            "city": "SNEADS FERRY",
            "state": "NC",
            "postal_code": "284606012",
            "telephone_number": "860-462-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 SEA HUNTER WAY",
            "city": "SNEADS FERRY",
            "state": "NC",
            "postal_code": "284606012",
            "telephone_number": "860-462-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEBER",
        "first_name": "ANDREW",
        "credential": "SOIDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOIDC",
            "identifier": "L02A",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Other",
            "affiliation": "N",
            "address_1": "BLDG A66",
            "city": "Camp Lejeune",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Schuster, SO-IDC
• Michael Garret Schut, DMD
• Shanie Singh Covert DDS PA
• Miranda Sharp, LCSW
• Mackenzie Shuford, D.C.
• Molly Simmons
• Steven William Smith Jr., D.D.S.
• Trisha Jean L Smith, MPH, LPN
• Sneads Ferry Family Pharmacy Inc
• Sneads Ferry Medical Clinic PA

• All providers in Sneads Ferry, NC
• Independent Duty Corpsman in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.