KELLY MATTHEW RAY CRNA
NPI 1417345836
Nurse Anesthetist, Certified Registered in Jackson, MS
About Kelly Matthew Ray Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY MATTHEW RAY CRNA (NPI 1417345836) is an individual nurse anesthetist, certified registered in Jackson, Mississippi, licensed in Mississippi (R885450) and active in the NPI registry since January 2015. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelly Matthew Ray Crna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
10Medicare enrollment records show Kelly Ray reassigns Medicare billing to 10 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Jackson, MS 39216
- Reassigned Medicare billing, Mississippi enrollment
- 86 clinicians in this Medicare group
Greenville, MS 38703
- Reassigned Medicare billing, Mississippi enrollment
- 32 clinicians in this Medicare group
Gulfport, MS 39503
- Reassigned Medicare billing, Mississippi enrollment
- 17 clinicians in this Medicare group
Oxford, MS 38655
- Reassigned Medicare billing, Mississippi enrollment
- 122 clinicians in this Medicare group
Biloxi, MS 39531
- Reassigned Medicare billing, Mississippi enrollment
- 9 clinicians in this Medicare group
New Iberia, LA 70563
- Reassigned Medicare billing, Mississippi enrollment
- 54 clinicians in this Medicare group
Memphis, TN 38125
- Reassigned Medicare billing, Mississippi enrollment
- 284 clinicians in this Medicare group
Fort Smith, AR 72903
- Reassigned Medicare billing, Arkansas enrollment
- 168 clinicians in this Medicare group
Fort Smith, AR 72903
- Reassigned Medicare billing, Arkansas enrollment
- 60 clinicians in this Medicare group
Fort Smith, AR 72903
- Reassigned Medicare billing, Arkansas enrollment
- 52 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 2
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 39216 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.
Reported Quality Measures
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.
JACKSON, MS 39216
JACKSON, MS 39216
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 Kelly Ray's NPI number?
The NPI number for Kelly Ray is 1417345836. It was assigned to this individual provider in the NPPES registry on January 7, 2015.
Where is Kelly Ray located?
Kelly Ray practices at 971 Lakeland Dr Suite 202, Jackson, MS 39216. The listed phone number is (601) 362-1990.
What is Kelly Ray's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Kelly Ray enrolled in Medicare?
Yes. Kelly Ray is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Kelly Ray's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Ray reassigns Medicare benefits to 10 organizations: Physicians Anesthesia Group, P.A. (Jackson, MS), Delta Health System (Greenville, MS), Gulf Anesthesia Services LLC (Gulfport, MS), Willow Anesthesia Services LLC (Oxford, MS), Seahorse Anesthesia (Biloxi, MS) and 5 more organizations, listed in the Medicare section above. 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 Kelly Ray's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly Ray accept?
Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage and Octave list Kelly Ray as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kelly Ray was last updated on January 7, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Kelly Matthew Ray, CRNA · NPI 1417345836
Nurse Anesthetist, Certified Registered physician in Jackson, Mississippi. Individual provider, active in the CMS NPPES registry since January 7, 2015.
## Identity
- **NPI:** 1417345836 (Entity type: Individual)
- **Enumerated:** January 7, 2015
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** R885450 (Mississippi)
- **Sole proprietor:** No
## Practice location
- **Address:** 971 LAKELAND DR, SUITE 202, Jackson, MS 39216-4643
- **Phone:** (601) 362-1990
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging
- **Bills Medicare through:** 10 organizations under Medicare reassignment (form CMS-855R): Physicians Anesthesia Group, P.A. (NPI 1407890783, Jackson, MS); Delta Health System (NPI 1447818026, Greenville, MS); Gulf Anesthesia Services LLC (NPI 1548696925, Gulfport, MS); Willow Anesthesia Services LLC (NPI 1205169521, Oxford, MS); Seahorse Anesthesia (NPI 1588497705, Biloxi, MS); and 5 more · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 7, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1417345836) · Data from the CMS NPPES public registry.