Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MR. JONATHAN BROCKMEYER MARDIS DNP, CRNA
NPI 1215746698
Nurse Anesthetist, Certified Registered in Hattiesburg, MS

Q: What is Jonathan Mardis's NPI number?

The NPI number for Jonathan Mardis is 1215746698. It was assigned to this individual provider in the NPPES registry on December 31, 2024.

Q: What is Jonathan Mardis's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Mardis was last updated on September 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days 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 December 31, 2024

415 S 28TH AVE, HATTIESBURG, MS 39401(601) 261-3606(601) 579-5383 Get Directions Write a Review

NPPES record last updated: September 30, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 30, 2026, Dec 31, 2024 (2 updates tracked since 2024).

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About Mr. Jonathan Brockmeyer Mardis Dnp, Crna NPPES

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

MR. JONATHAN BROCKMEYER MARDIS DNP, CRNA (NPI 1215746698) is an individual nurse anesthetist, certified registered in Hattiesburg, Mississippi, licensed in Mississippi (152511) and active in the NPI registry since December 2024. He is affiliated with Novant Health Presbyterian Medical Center, maintains a secondary practice location in Charlotte, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1215746698

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameMR. JONATHAN BROCKMEYER MARDISCredential: DNP, CRNA

Location Address415 S 28TH AVEHattiesburg, MS 39401-7246

Mailing Address1290 W Government St Apt T158Brandon, MS 39042-2445 · (601) 938-0322

Phone(601) 261-3606

Fax(601) 579-5383

Sole ProprietorYes

Medical School CMSOtherGraduated 2024

Enumeration DateDecember 31, 2024

Last NPPES UpdateSeptember 30, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 30, 2026

✔ NPI 1215746698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in MS · 152511

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

415 S 28TH AVE, Hattiesburg, MS 39401

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Secondary Practice Location 1

Location 1200 Hawthorne LnCharlotte, NC 28204-2515 · Phone (704) 384-4000

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Jonathan Brockmeyer Mardis Dnp, Crna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5799207171

PECOS Enrollment IDI20250314000506

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Novant Health Presbyterian Medical Center

Acute Care Hospitals · Charlotte, NC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340053

Location200 Hawthorne Lane Box 33549Charlotte, NC 28233 · Mecklenburg County

Emergency services Birthing friendly

Novant Health Matthews Medical Center

Acute Care Hospitals · Matthews, NC

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number340171

Location1500 Matthews Twnshp Prkwy Box 3310Matthews, NC 28106 · Mecklenburg County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

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

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