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PHILLIPS RUTH DERIDDER MD
NPI 1124512454
Pediatrics - Pediatric Critical Care Medicine in Columbia, SC

Active since June 20, 2018PECOS Enrolled
9 RICHLAND MEDICAL PARK DR STE 530, COLUMBIA, SC 29203(803) 434-4603(803) 434-7983 Get Directions Write a Review

NPPES record last updated: December 8, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 8, 2025, Jun 20, 2018 (2 updates tracked since 2018).

About Phillips Ruth Deridder Md NPPES

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

PHILLIPS RUTH DERIDDER MD (NPI 1124512454) is an individual pediatric critical care medicine provider in Columbia, South Carolina, licensed in South Carolina (52457) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS and is a graduate of University Of South Carolina School Of Medicine, Greenville (2018).

NPPES Registry Identity

NPI1124512454
Entity TypeIndividualFemale
Primary Taxonomy2080P0203X
Provider Legal NamePHILLIPS RUTH DERIDDERCredential: MD
Location Address9 RICHLAND MEDICAL PARK DR STE 530Columbia, SC 29203-6870
Mailing Address300 E Mcbee Ave Fl 4Greenville, SC 29601-2842 · (864) 695-6697
Phone(803) 434-4603
Fax(803) 434-7983
Sole ProprietorNo
Medical School CMSUniversity Of South Carolina School Of Medicine, GreenvilleGraduated 2018
Enumeration DateJune 20, 2018
Last NPPES UpdateDecember 8, 20252 updates tracked since enumeration
NPPES CertifiedDecember 8, 2025
✔ NPI 1124512454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0203X
License✔ Licensed in SC · 52457
Definition
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Also ListedInternal MedicineTaxonomy 207R00000X · License LL52457 (SC)
Also ListedPediatricsTaxonomy 208000000X · License LL52457 (SC)
9 RICHLAND MEDICAL PARK DR STE 530, Columbia, SC 29203
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phillips Ruth Deridder Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1254682370
PECOS Enrollment IDI20251220000131
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

EMILY FOREMAN INGRAM
Pediatrics (Pediatric Critical Care Medicine)
9 RICHLAND MEDICAL PARK DR STE 530
COLUMBIA, SC 29203
Richland County (803) 434-4603
JASON RUSSELL PECK MD
Pediatrics (Pediatric Critical Care Medicine)
9 RICHLAND MEDICAL PARK DR STE 530
COLUMBIA, SC 29203
Richland County (803) 434-4603
JORDAN HALL DENT MD
Pediatrics (Pediatric Critical Care Medicine)
9 RICHLAND MEDICAL PARK DR STE 530
COLUMBIA, SC 29203
Richland County (803) 434-4603
PALMETTO HEALTH - UNIVERSITY OF SOUTH CAROLINA MEDICAL GROUP
Hospitalist
9 RICHLAND MEDICAL PARK DR STE 530
COLUMBIA, SC 29203
Richland County (803) 434-4603
DR. MICHAEL DENNIS DALLMAN M.D.
Pediatrics (Pediatric Critical Care Medicine)
9 RICHLAND MEDICAL PARK DR STE 530
COLUMBIA, SC 29203
Richland County (803) 434-4603
ISABELLE MARIE RILEY MD
Pediatrics (Pediatric Critical Care Medicine)
9 RICHLAND MEDICAL PARK DR STE 530
COLUMBIA, SC 29203
Richland County (803) 434-4603

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 Phillips Deridder's NPI number?

The NPI number for Phillips Deridder is 1124512454. It was assigned to this individual provider in the NPPES registry on June 20, 2018.

Where is Phillips Deridder located?

Phillips Deridder practices at 9 Richland Medical Park Dr Ste 530, Columbia, SC 29203. The listed phone number is (803) 434-4603.

What is Phillips Deridder's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Is Phillips Deridder enrolled in Medicare?

Yes. Phillips Deridder is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Phillips Deridder was last updated on December 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.