MR. MARIO DELANO PHILLIPS JR. (NPI# 1336582774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336582774 |
| Entity Type | Individual |
| Full Name | MR. MARIO DELANO PHILLIPS JR. |
| Credential | IDC |
| Practice Address |
745 Eden Way North Chesapeake VA 23320 |
| Mailing Address |
Marine Corps Security Forces Mca 614 Port Au Prince Norfolk VA 23551-0001 |
| Practice Telephone | 7575602457 |
| Mailing Telephone | 7574446492 |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2013-04-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
745 EDEN WAY NORTH |
| City | CHESAPEAKE |
| State | VA |
| Zip Code | 23320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386263499 | Trinity Hospice 1, LLC | Hospice Care, Community Based | 1401 Kempsville Road, Suite A, Unit 1, Chesapeake, VA 23320 | 2020-04-09 |
| 1538624804 | Shaniqah Mcleod | Home Health | 217 Centerville Turnpike N, Chesapeake, VA 23320 | 2019-01-31 |
| 1942764113 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1400 Kempsville Rd, Virginia Beach, VA 23320 | 2019-01-22 |
| 1639647993 | Madison Vansavage Maben | Orthotist | 433 Network Sta, Chesapeake, VA 23320 | 2018-11-05 |
| 1568947356 | Kelly M Muchetti | Massage Therapist | 1421 C. Kempsville Rd., Chesapeake, VA 23320 | 2018-09-27 |
| 1235612912 | L&s Home Health Care, LLC. | Home Health | 1545 Cossways Blv, Chesepeake, VA 23320 | 2018-09-10 |
| 1154803500 | Latricia A Patterson | Home Health | 813-a Professional Pl Ste 107, Chesapeake, VA 23320 | 2018-09-02 |
| 1164909586 | 4k Tresses | Durable Medical Equipment & Medical Supplies | 1220 Executive Blvd Ste 101, Chesapeake, VA 23320 | 2018-07-27 |
| 1831676105 | Lance Taylor | Technician | 1645 Crossways Blvd Ste 250, Chesapeake, VA 23320 | 2018-07-19 |
| 1023507688 | Sentoria Howell Harold | Social Worker | 920 Ventures Way Ste 4, Chesapeake, VA 23320 | 2018-05-08 |
| Find all providers in zip 23320 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| 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. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346661550 | Angel Daniel Rendon | Military Health Care Provider | 865 Royal Grove Ct, Chesapeake, VA 23320-6564 | 2013-12-16 |
| 1366872772 | Matthew John Watton | Military Health Care Provider | 1414 Sabbath Ln, Chesapeake, VA 23320-3348 | 2013-11-21 |
| 1932533601 | Ernesto Carrasquillo IIi | Military Health Care Provider | 1804 Crestmont Place, Apt 302, Chesapeake, VA 23320 | 2013-08-29 |
| 1871845313 | Jennifer Renee Otterbach | Military Health Care Provider | 4000 Hailey Ct, Chesapeake, VA 23321-3137 | 2012-10-08 |
| 1588925754 | Christian Marsh | Military Health Care Provider | 707 Washington Dr, Chesapeake, VA 23322-7327 | 2012-06-05 |
| 1982977153 | Michael Thomas Hedden | Military Health Care Provider | 1317 Richwood Ave, Chesapeake, VA 23323-5746 | 2012-02-17 |
| 1801126289 | Daniel Michael Covitz | Military Health Care Provider | 1317 Ballahack Rd. Ste 100, Capt W.l. Mcgonagle Branch Clinic Nsa Northwest, Chesapeake, VA 23322-2463 | 2010-01-06 |
| 1538319223 | Christopher Golden | Military Health Care Provider | 201 Thoroughbred Ln, Chesapeake, VA 23320-3061 | 2008-09-30 |
| 1902069990 | Huben Lindale Phillips | Military Health Care Provider | 2803 Meadow Wood Ct W, Chesapeake, VA 23321-4228 | 2008-07-09 |
| 1649439605 | Louis Eugene Raiford | Military Health Care Provider | 217 Heritage Oak Dr, Chesapeake, VA 23320-9501 | 2008-06-05 |
| Find all providers in CHESAPEAKE | ||||
| City | CHESAPEAKE |
| Zip Code | 23320 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.