DR. RUSSELL WAYNE GRAY CRNA
NPI 1215697388
Nurse Anesthetist, Certified Registered in Hattiesburg, MS
About Dr. Russell Wayne Gray Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. RUSSELL WAYNE GRAY CRNA (NPI 1215697388) is an individual nurse anesthetist, certified registered in Hattiesburg, Mississippi, licensed in Mississippi (901751) and active in the NPI registry since December 2021. He is enrolled in Medicare PECOS, is affiliated with Forrest General Hospital, and maintains a secondary practice location in Hattiesburg.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Russell Wayne Gray Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Russell Gray reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Hattiesburg, MS 39402
- Reassigned Medicare billing, Mississippi enrollment
- 696 clinicians in this Medicare group
Memphis, TN 38125
- Reassigned Medicare billing, Mississippi enrollment
- 284 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Forrest General Hospital
Acute Care Hospitals · Hattiesburg, MSMerit Health Wesley
Acute Care Hospitals · Hattiesburg, MSPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 39402 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
HATTIESBURG, MS 39402
HATTIESBURG, MS 39402
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Russell Gray's NPI number?
The NPI number for Russell Gray is 1215697388. It was assigned to this individual provider in the NPPES registry on December 30, 2021.
Where is Russell Gray located?
Russell Gray practices at 5001 Hardy St, Hattiesburg, MS 39402. The listed phone number is (601) 319-5647.
What is Russell Gray's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Russell Gray enrolled in Medicare?
Yes. Russell Gray is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Russell Gray's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Russell Gray reassigns Medicare benefits to 2 organizations: Hattiesburg Clinic PA (Hattiesburg, MS) and Lifelinc Anesthesia, PLLC (Memphis, TN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Russell Gray's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Russell Gray affiliated with any hospitals?
According to CMS data, Russell Gray is affiliated with Forrest General Hospital and Merit Health Wesley.
When was this NPI record last updated?
The NPPES record for Russell Gray was last updated on August 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Russell Wayne Gray, CRNA · NPI 1215697388
Nurse Anesthetist, Certified Registered physician in Hattiesburg, Mississippi. Individual provider, active in the CMS NPPES registry since December 30, 2021.
## Identity
- **NPI:** 1215697388 (Entity type: Individual)
- **Enumerated:** December 30, 2021
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 901751 (Mississippi)
- **Sole proprietor:** No
## Practice location
- **Address:** 5001 HARDY ST, Hattiesburg, MS 39402-1308
- **Phone:** (601) 319-5647
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Hattiesburg Clinic PA (NPI 1851488118, Hattiesburg, MS); Lifelinc Anesthesia, PLLC (NPI 1801021464, Memphis, TN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** August 7, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1215697388) · Data from the CMS NPPES public registry.