Krystal Ealy, MS, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

C7-0018563 Issued in DE

Practice address

1600 Rockland Rd
Wilmington, DE 19803-3607

Phone

(302) 577-0319

NPI assigned

May 3, 2021

Last updated

Jun 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1467035030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607",
            "telephone_number": "302-577-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607",
            "telephone_number": "302-577-0319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EALY",
        "first_name": "KRYSTAL",
        "name_prefix": "Dr.",
        "credential": "MS, MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DE",
            "license": "C7-0018563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Pediatrics Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.