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RUSSELL JENNINGS RIDER IDC
NPI 1609416189
Military Health Care Provider - Independent Duty Corpsman in Groton, CT

Active since January 13, 2020
159 TROUT AVE, GROTON, CT 06340(860) 694-6464 Get Directions Write a Review

NPPES record last updated: January 13, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Russell Jennings Rider Idc NPPES

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

RUSSELL JENNINGS RIDER IDC (NPI 1609416189) is an individual independent duty corpsman provider in Groton, Connecticut and active in the NPI registry since January 2020.

NPPES Registry Identity

NPI1609416189
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameRUSSELL JENNINGS RIDERCredential: IDC
Location Address159 TROUT AVEGroton, CT 06340
Mailing Address140 Cherry CirGroton, CT 06340-3157 · (860) 617-0344
Phone(860) 694-6464
Sole ProprietorYes
Enumeration DateJanuary 13, 2020
✔ NPI 1609416189 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.
159 TROUT AVE, Groton, CT 06340
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Other Providers at the Same Location NPPES 6

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

ANDREW TRISTAN BELL IDC
Military Health Care Provider (Independent Duty Corpsman)
159 TROUT AVE
NEW LONDON, CT 06340
Southeastern Connecticut Planning Region (760) 406-3791
AUSTIN BEAUDEAN LENZI
Military Health Care Provider (Independent Duty Corpsman)
159 TROUT AVE
GROTON, CT 06340
Southeastern Connecticut Planning Region (860) 694-6450
BRYAR TAYLOR GREEN
Military Health Care Provider (Independent Duty Corpsman)
159 TROUT AVE
GROTON, CT 06340
Southeastern Connecticut Planning Region (860) 694-2876
ADAM S GREEN
Military Health Care Provider (Independent Duty Corpsman)
159 TROUT AVE
GROTON, CT 06340
Southeastern Connecticut Planning Region (661) 203-1325
MR. GEORGE CHARLES FRICKE
Military Health Care Provider (Independent Duty Corpsman)
159 TROUT AVE
GROTON, CT 06340
Southeastern Connecticut Planning Region (904) 673-1037
ANTHONY J GERVASI IDC
Military Health Care Provider (Independent Duty Corpsman)
159 TROUT AVE
GROTON, CT 06340
Southeastern Connecticut Planning Region (860) 694-6450

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 Russell Rider's NPI number?

The NPI number for Russell Rider is 1609416189. It was assigned to this individual provider in the NPPES registry on January 13, 2020.

Where is Russell Rider located?

Russell Rider practices at 159 Trout Ave, Groton, CT 06340. The listed phone number is (860) 694-6464.

What is Russell Rider'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 Russell Rider was last updated on January 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.