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NICHOLAS GREGORY WATTERS SUB IDC
NPI 1114400918
Military Health Care Provider - Independent Duty Corpsman in Groton, CT

Active since September 08, 2018

NPPES record last updated: May 6, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 6, 2025, Sep 8, 2018 (2 updates tracked since 2018).

About Nicholas Gregory Watters Sub Idc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICHOLAS GREGORY WATTERS SUB IDC (NPI 1114400918) is an individual independent duty corpsman provider in Groton, Connecticut and active in the NPI registry since September 2018.

NPPES Registry Identity

NPI1114400918
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameNICHOLAS GREGORY WATTERSCredential: SUB IDC
Location Address1 WAHOO AVEGroton, CT 06349-2324
Mailing Address212 Brunners LnMoncks Corner, SC 29461-8896 · (808) 979-5637
Phone(904) 680-8007
Sole ProprietorNo
Enumeration DateSeptember 8, 2018
Last NPPES UpdateMay 6, 20252 updates tracked since enumeration
NPPES CertifiedMay 6, 2025
✔ NPI 1114400918 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
Definition
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
1 WAHOO AVE, Groton, CT 06349
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILLIAM DON MURPHY III IDC
Military Health Care Provider (Independent Duty Corpsman)
1 WAHOO AVE
GROTON, CT 06349
Southeastern Connecticut Planning Region (860) 694-4123
SARAH ELISABETH HIRSCHKOWITZ
Registered Nurse (Case Management)
1 WAHOO AVE
GROTON, CT 06349
Southeastern Connecticut Planning Region (860) 694-4026
COREY ROBIN WILFON
Military Health Care Provider (Independent Duty Corpsman)
1 WAHOO AVE
GROTON, CT 06349
Southeastern Connecticut Planning Region (860) 694-4123
MATTHEW DAVID COOPER APRN
Nurse Practitioner (Family)
1 WAHOO AVE
GROTON, CT 06349
Southeastern Connecticut Planning Region (860) 694-4123
DR. MATTHEW BRADEN BURNS MILLER DDS
Dentist (Periodontics)
1 WAHOO AVE
GROTON, CT 06349
Southeastern Connecticut Planning Region (860) 694-3094
KORIN MESSINA RN
Registered Nurse (Case Management)
1 WAHOO AVE
GROTON, CT 06349
Southeastern Connecticut Planning Region (860) 694-2388
DR. JULIA JACOBS M.D.
Psychiatry & Neurology (Psychiatry)
1 WAHOO AVE
GROTON, CT 06349
Southeastern Connecticut Planning Region (860) 694-4496
DR. JIMMY NAZIH SULIMAN DDS
Dentist (General Practice)
1 WAHOO AVE
GROTON, CT 06349
Southeastern Connecticut Planning Region (860) 694-3738

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholas Watters's NPI number?

The NPI number for Nicholas Watters is 1114400918. It was assigned to this individual provider in the NPPES registry on September 8, 2018.

Where is Nicholas Watters located?

Nicholas Watters practices at 1 Wahoo Ave, Groton, CT 06349. The listed phone number is (904) 680-8007.

What is Nicholas Watters's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Nicholas Watters was last updated on May 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.