Robert Dale Ealy Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5077 Issued in NC

Practice address

300 Enola Rd
J Iverson Riddle Developmental Center/DHHS/NC
Morganton, NC 28655-4608

Phone

(828) 433-2639

Fax

(828) 433-2694

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1114095247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 ENOLA RD",
            "address_2": "J IVERSON RIDDLE DEVELOPMENTAL CENTER/DHHS/NC",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554608",
            "telephone_number": "828-433-2639",
            "fax_number": "828-433-2694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ENOLA RD",
            "address_2": "J IVERSON RIDDLE DEVELOPMENTAL CENTER/DHHS/NC",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286554608",
            "telephone_number": "828-433-2639",
            "fax_number": "828-433-2694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EALY",
        "first_name": "ROBERT",
        "middle_name": "DALE",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "5077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8992282",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Duerson, MED, LPCC, LCMHC
• Lela J Duke, B.S., P.T.
• Heather Dula, CCC-SLP
• Anna Bowman Duncan, PHARMD
• Becky Campbell Duncan, LCSWA
• Easter Seals Ucp North Carolina & Virginia, Inc.
• Easter Seals Ucp North Carolina & Virginia, Inc.
• Easter Seals Ucp of North Carolina & Virginia, Inc.
• Easter Seals Ucp of North Carolina & Virginia, Inc.
• Eckerd Corporation

• General Practice Dentistry in Morganton, NC
• Providers in Morganton, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.