David Andrew Peterson Jr.

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

Nomi Det Numi Submarine Base Nlon
Building 159
Groton, CT 06349

Phone

(860) 694-2876

Fax

(860) 694-3874

NPI assigned

Mar 8, 2006

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

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639147606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 HICKORY ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063604634",
            "telephone_number": "860-514-5293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NOMI DET NUMI SUBMARINE BASE NLON",
            "address_2": "BUILDING 159",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06349",
            "telephone_number": "860-694-2876",
            "fax_number": "860-694-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DAVID",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT DUTY CORPSMAN",
            "identifier": "1710I1002X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Angela Pereira, LCSW
• Bethzaida Perez Villegas, LMSW
• Christine Perkins, MA
• Lori A Perry, LCSW
• Lydia Prudence Perry, LPC, LADC
• Kenneth R Peterson, D.C.
• Lauren Pettit, BS
• Kristin Pezzolesi, RDH
• Phalanx Med Connecticut, LLC
• David Phelps Jr., DDS

• Independent Duty Corpsman in Groton, CT
• Providers in Groton, CT by specialty
• Independent Duty Corpsman in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.