Mario Delano Phillips Jr., IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

745 Eden Way North
Chesapeake, VA 23320

Phone

(757) 560-2457

NPI assigned

Apr 16, 2013

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1336582774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MARINE CORPS SECURITY FORCES",
            "address_2": "MCA 614 PORT AU PRINCE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235510001",
            "telephone_number": "757-444-6492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 EDEN WAY NORTH",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "23320",
            "telephone_number": "757-560-2457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARIO",
        "middle_name": "DELANO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "IDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-16",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Phillips
• Angelica Phillips
• Ashley M Phillips
• Huben Lindale Phillips, IDC
• Lisa Owens Phillips, MS, OTR/L
• Martin Wynn Phillips, L.P.C.
• Physiatry-Sports & Family Medicine, LLC
• John G Piacenti, DPM
• Frank Joseph Piccioni, D.O.
• Janelle Voight Pickering, DNP, CRNA

• Independent Duty Corpsman in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Independent Duty Corpsman in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.