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JERRICSON BARLIS PERALTA IDC
NPI 1740719814
Military Health Care Provider - Independent Duty Corpsman in Kittery, ME

Active since June 12, 2017
402 GOODRICH AVENUE, KITTERY, ME 03904(207) 438-1781 Get Directions Write a Review

NPPES record last updated: January 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jerricson Barlis Peralta Idc NPPES

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

JERRICSON BARLIS PERALTA IDC (NPI 1740719814) is an individual independent duty corpsman provider in Kittery, Maine and active in the NPI registry since June 2017.

NPPES Registry Identity

NPI1740719814
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameJERRICSON BARLIS PERALTACredential: IDC
Location Address402 GOODRICH AVENUEKittery, ME 03904
Mailing Address6850 Mission Gorge Rd Apt 1248San Diego, CA 92120-2478 · (818) 263-5345
Phone(207) 438-1781
Sole ProprietorNo
Enumeration DateJune 12, 2017
Last NPPES UpdateJanuary 27, 2025
NPPES CertifiedJanuary 27, 2025
✔ NPI 1740719814 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.
402 GOODRICH AVENUE, Kittery, ME 03904
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Other Providers at the Same Location NPPES 4

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

DR. ELIZABETH JOSEPH DDS, MA
Dentist
402 GOODRICH AVENUE
KITTERY, ME 03904
York County (207) 438-1714
MS. TERRI LYNN AUBIN LICSW
Social Worker (Clinical)
402 GOODRICH AVENUE
KITTERY, ME 03904
York County (207) 438-5722
NATALIE GETTY
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
402 GOODRICH AVENUE
KITTERY, ME 03904
York County (207) 438-6951
JAN VANDERLINDE MD
Preventive Medicine (Occupational Medicine)
402 GOODRICH AVENUE
KITTERY, ME 03904
York County (207) 438-5981

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 Jerricson Peralta's NPI number?

The NPI number for Jerricson Peralta is 1740719814. It was assigned to this individual provider in the NPPES registry on June 12, 2017.

Where is Jerricson Peralta located?

Jerricson Peralta practices at 402 Goodrich Avenue, Kittery, ME 03904. The listed phone number is (207) 438-1781.

What is Jerricson Peralta'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 Jerricson Peralta was last updated on January 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.