PHILIP MARDOCK
NPI 1447900949
Student in an Organized Health Care Education/Training Program in Myrtle Beach, SC

Q: What is Philip Mardock's NPI number?

The NPI number for Philip Mardock is 1447900949. It was assigned to this individual provider in the NPPES registry on March 27, 2022.

Q: What is Philip Mardock's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Philip Mardock was last updated on March 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 27, 2022PECOS Enrolled

809 82ND PKWY, MYRTLE BEACH, SC 29572(843) 692-1118(843) 692-1122 Get Directions Write a Review

NPPES record last updated: March 28, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Philip Mardock NPPES

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

PHILIP MARDOCK (NPI 1447900949) is an individual student in an organized health care education/training program in Myrtle Beach, South Carolina and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1447900949

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NamePHILIP MARDOCK

Location Address809 82ND PKWYMyrtle Beach, SC 29572-4607

Mailing Address2021 N Sizer Ave Apt 224Jefferson City, TN 37760-5149 · (703) 317-7835

Phone(843) 692-1118

Fax(843) 692-1122

Sole ProprietorNo

Enumeration DateMarch 27, 2022

Last NPPES UpdateMarch 28, 2022

NPPES CertifiedMarch 28, 2022

✔ NPI 1447900949 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

809 82ND PKWY, Myrtle Beach, SC 29572

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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)

Philip Mardock is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 20

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

SOUTHEASTERN HOSPITALIST SERVICES PC

Hospitalist