Active NPI
Krystal Medical Associates
- In Home Supportive Care Agency
- Annandale, VA
National Provider Identifier
1578248787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Legal business name
- KRYSTAL MEDICAL ASSOCIATES
- Practice address
- 3602 Balin CT
Annandale, VA 22003-1301 - Phone
- (703) 209-0363
- NPI assigned
- Jun 16, 2023
- Organization subpart
- Yes
- Parent organization
- KRYSTAL MEDICAL ASSOCIATES LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Nwaehihie Harrison Onyeaghala, MD
- Title
- Ceo
- Phone
- (703) 209-0363
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
3602 Balin CT
Annandale, VA 22003-1301
Mailing address
3602 Balin CT
Annandale, VA 22003-1301
Phone (703) 209-0363
National Provider Directory
National Provider Directory- Tax ID family
- Krystal Medical Associates LLC
- Part of
- Krystal Medical Associates LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Krystal Medical Associates
- Primary Care Clinic/Center
- Glenn Dale, MD
- NPI 1164604187
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Physician
- Glenn Dale, MD
- NPI 1114938800
-
- Case Manager/Care Coordinator
- Hyattsville, MD
- NPI 1639042054
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686873600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1686873600000",
"number": "1578248787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3602 BALIN CT",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "220031301",
"telephone_number": "703-209-0363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3602 BALIN CT",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "220031301",
"telephone_number": "703-209-0363"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KRYSTAL MEDICAL ASSOCIATES",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "KRYSTAL MEDICAL ASSOCIATES LLC",
"enumeration_date": "2023-06-16",
"last_updated": "2023-06-16",
"certification_date": "2023-06-16",
"status": "A",
"authorized_official_last_name": "ONYEAGHALA",
"authorized_official_first_name": "NWAEHIHIE",
"authorized_official_middle_name": "HARRISON",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "703-209-0363",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Annandale, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.