KELLY GRANT EZZELL ARNP - NPI 1760906184 - Nurse Practitioner in Wilmington, NC

Q: What is Kelly Ezzell's NPI number?

The NPI number for Kelly Ezzell is 1760906184. It was assigned to this individual provider in the NPPES registry on July 27, 2017.

Q: What is Kelly Ezzell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Ezzell was last updated on July 10, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

On this page

About Kelly Grant Ezzell Arnp NPPES

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

KELLY GRANT EZZELL ARNP (NPI 1760906184) is an individual pediatrics provider in Wilmington, North Carolina, licensed in North Carolina (319192) and active in the NPI registry since July 2017. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Medical University Of South Carolina College Of Medicine (2017).

NPPES Registry Identity

NPI1760906184

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameKELLY GRANT EZZELLCredential: ARNP

Location Address1501 DOCK STWilmington, NC 28401-4936

Mailing Address1501 Dock StWilmington, NC 28401-4936 · (910) 254-9898

Phone(910) 254-9898

Sole ProprietorNo

Medical School CMSMedical University Of South Carolina College Of MedicineGraduated 2017

Enumeration DateJuly 27, 2017

Last NPPES UpdateJuly 10, 20265 updates tracked since enumeration

NPPES CertifiedJuly 10, 2026

✔ NPI 1760906184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in NC · 319192

Also ListedUrology · Pediatric UrologyTaxonomy 2088P0231X · License ARNP9384638 (FL)

Also ListedNurse PractitionerTaxonomy 363L00000X · License ARNP9384638 (FL)

1501 DOCK ST, Wilmington, NC 28401

Open in Google Maps ↗

Secondary Practice Locations 2

Location 1545 Michael Martin RdMount Olive, NC 28365-1131 · Phone (252) 737-3330 · Fax (252) 737-3331

Location 22303 Executive CirGreenville, NC 27834-3749 · Phone (252) 744-8334 · Fax (252) 744-8335

Other Identifiers 1

Medicaid022054500FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Grant Ezzell Arnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5991070740

PECOS Enrollment IDI20251003001311

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

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

MS. LISA M BROOKS MSW, LCSW

Counselor (Mental Health)