Individual provider Active NPI

Michael Shoener, IDC

  • Independent Duty Corpsman
  • Camp Lejeune, NC
National Provider Identifier
1821468042
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
212 Wallace Creek Rd
Camp Lejeune, NC 28547
Phone
(910) 451-8847
NPI assigned
Sep 30, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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 Primary

Addresses

Primary practice location

212 Wallace Creek Rd
Camp Lejeune, NC 28547

Mailing address

PSC Box 20085
Fpo, AA 28542
Phone (910) 451-8847

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": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1821468042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "PSC BOX 20085",
            "city": "FPO",
            "state": "AA",
            "postal_code": "28542",
            "telephone_number": "910-451-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 WALLACE CREEK RD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "28547",
            "telephone_number": "910-451-8847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOENER",
        "first_name": "MICHAEL",
        "credential": "IDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-30",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "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 Sep 18, 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.