Theodore Sherman Branch

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

Commanind Offcer 2D Reconnaissance Battalion
Camp Lejuene, NC 28546

Phone

(201) 951-8952

NPI assigned

Feb 10, 2021

Last updated

Feb 10, 2021By the provider in NPPES

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

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1922690072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COMMANDING OFFICER 2D RECONNAISSANCE BATTALION",
            "address_2": "PSC BOX 20138",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420138",
            "telephone_number": "910-440-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COMMANIND OFFCER 2D RECONNAISSANCE BATTALION",
            "city": "CAMP LEJUENE",
            "state": "NC",
            "postal_code": "28546",
            "telephone_number": "201-951-8952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANCH",
        "first_name": "THEODORE",
        "middle_name": "SHERMAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-01-22",
        "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": []
}

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• Christopher W Clark, L.A.T., A.T.C.
• Rocky Foster, IDC
• Kyle Weston Holbrook, IDC
• David John McDermott, ATC

• Independent Duty Corpsman in Camp Lejuene, NC
• Providers in Camp Lejuene, 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 Feb 10, 2021; 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.