Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jedidiah E. Johnson, HS1, IDC

Individual provider Independent Duty Corpsman · NPI 1114000130

Jedidiah E. Johnson, HS1, IDC is an Independent Duty Corpsman in Homer, Alaska. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
Specialties on file
2

Practice location Address checks out

4688 Homer Spit Rd
Homer, AK 99603-8001
Phone: (360) 567-8238
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X (CA)
Other Technician Taxonomy 247200000X

Record details

NPI number1114000130
Entity typeIndividual (Type 1)
GenderMale
Credentials HS1 , IDC
Sole proprietorNo
NPI enumeratedOctober 23, 2006
Last updated in NPPESOctober 8, 2013
Mailing address4688 Homer Spit Rd, Uscgc Hickory, Homer, AK 99603