MR. RANDALL FREDERICK DIERKING JR. IDC
NPI 1790752111
Military Health Care Provider - Independent Duty Corpsman in Groton, CT

Q: What is Randall Dierking's NPI number?

The NPI number for Randall Dierking is 1790752111. It was assigned to this individual provider in the NPPES registry on March 3, 2006.

Q: What is Randall Dierking's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Randall Dierking was last updated on May 3, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

Active since March 03, 2006

1 WAHOO AVE, UNDERSEA MEDICINE, GROTON, CT 06340(860) 449-4247 Get Directions Write a Review

NPPES record last updated: May 3, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Randall Frederick Dierking Jr. Idc NPPES

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

MR. RANDALL FREDERICK DIERKING JR. IDC (NPI 1790752111) is an individual independent duty corpsman provider in Groton, Connecticut and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1790752111

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameMR. RANDALL FREDERICK DIERKING JR.Credential: IDC

Location Address1 WAHOO AVE, UNDERSEA MEDICINEGroton, CT 06340-2324

Mailing Address7 Hart StGroton, CT 06340-3321 · (860) 405-0343

Phone(860) 449-4247

Sole ProprietorNo

Enumeration DateMarch 3, 2006

Last NPPES UpdateMay 3, 2010

✔ NPI 1790752111 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 06340

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Other Providers at the Same Location NPPES 12

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

JOSHUA O BALTER NAVY IDC

Military Health Care Provider (Independent Duty Corpsman)

1 WAHOO AVE, SUBASE NLON
GROTON, CT 06340

Southeastern Connecticut Planning Region (860) 694-4123

MRS. RENAY MILLER BSC(PHARMACY)

Pharmacist

1 WAHOO AVE
GROTON, CT 06340

Southeastern Connecticut Planning Region (860) 694-2590

MR. STEVEN JAY DIFILIPPO LCSW

Social Worker (Clinical)

1 WAHOO AVE, NAVSUBASENLON
GROTON, CT 06340

Southeastern Connecticut Planning Region (860) 694-1637

DR. JOHN WILLIAM DORUNDA M.D.

Family Medicine

1 WAHOO AVE, NBHC GROTON
GROTON, CT 06340

Southeastern Connecticut Planning Region (860) 694-4123

PAUL B. SCHIOWITZ IDC

Military Health Care Provider

1 WAHOO AVE
GROTON, CT 06340

Southeastern Connecticut Planning Region (860) 694-7511

FREDERICK M LOMASNEY III

Military Health Care Provider (Independent Duty Corpsman)

1 WAHOO AVE
GROTON, CT 06340

Southeastern Connecticut Planning Region (860) 694-2876

ROY L UNDERWOOD SFIDC

Military Health Care Provider (Independent Duty Corpsman)

1 WAHOO AVE
GROTON, CT 06340

Southeastern Connecticut Planning Region (860) 694-5139

MS. LAURI NYMAN COLE B.S., R.PH.

Pharmacist

1 WAHOO AVE, NAVAL HEALTH CLINIC
GROTON, CT 06340

Southeastern Connecticut Planning Region (860) 694-4523

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 Randall Dierking's NPI number?

The NPI number for Randall Dierking is 1790752111. It was assigned to this individual provider in the NPPES registry on March 3, 2006.

Where is Randall Dierking located?

Randall Dierking practices at 1 Wahoo Ave Undersea Medicine, Groton, CT 06340. The listed phone number is (860) 449-4247.

What is Randall Dierking'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 Randall Dierking was last updated on May 3, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.