Individual provider Active NPI

Virgil Lee Ealy, RPH

  • Pharmacist
  • Brandon, FL
National Provider Identifier
1295338366
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS27859 Issued in FL
Practice address
2021 W Brandon Blvd
Brandon, FL 33511-4701
Phone
(813) 657-5441
NPI assigned
Nov 19, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS27859 FL Primary

Addresses

Primary practice location

2021 W Brandon Blvd
Brandon, FL 33511-4701

Mailing address

1221 E Powhatan Ave
Tampa, FL 33604-7231
Phone (813) 784-3536

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vlealy.s06403.us@samsclub.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PS27859FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1295338366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 E POWHATAN AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336047231",
            "telephone_number": "813-784-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 W BRANDON BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114701",
            "telephone_number": "813-657-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EALY",
        "first_name": "VIRGIL",
        "middle_name": "LEE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS27859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vlealy.s06403.us@samsclub.com",
            "affiliation": "N",
            "endpointDescription": "Business",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2021 W Brandon Blvd",
            "city": "Brandon",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335114701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.