KELLY GRAY HILL DALE MD
NPI 1801474549
Internal Medicine in Jackson, MS
About Kelly Gray Hill Dale Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY GRAY HILL DALE MD (NPI 1801474549) is an individual internal medicine provider in Jackson, Mississippi, licensed in Mississippi (T-4380) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS, is affiliated with University Of Mississippi Med Center, and is a graduate of University Of Mississippi School Of Medicine (2021).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
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
Kelly Gray Hill Dale Md 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 Reassignment
Medicare enrollment records show Kelly Dale reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Jackson, MS 39216
- Reassigned Medicare billing, Mississippi enrollment
- 1,932 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
University Of Mississippi Med Center
Acute Care Hospitals · Jackson, MSPhysician 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.
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 Dale's NPI number?
The NPI number for Kelly Dale is 1801474549. It was assigned to this individual provider in the NPPES registry on April 1, 2021.
Where is Kelly Dale located?
Kelly Dale practices at 2500 N State St, Jackson, MS 39216. The listed phone number is (601) 984-1000.
What is Kelly Dale's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Kelly Dale enrolled in Medicare?
Yes. Kelly Dale 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 organization bills Medicare for Kelly Dale's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Dale reassigns Medicare benefits to State Of Mississippi - University Of Mississippi Medical Center (Jackson, MS). The 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 Dale's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly Dale accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list Kelly Dale 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.
Is Kelly Dale affiliated with any hospitals?
According to CMS data, Kelly Dale is affiliated with University Of Mississippi Med Center.
When was this NPI record last updated?
The NPPES record for Kelly Dale was last updated on July 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 Gray Hill Dale, MD · NPI 1801474549
Internal Medicine physician in Jackson, Mississippi. Individual provider, active in the CMS NPPES registry since April 1, 2021.
## Identity
- **NPI:** 1801474549 (Entity type: Individual)
- **Enumerated:** April 1, 2021
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** T-4380 (Mississippi)
- **Sole proprietor:** No
## Practice location
- **Address:** 2500 N STATE ST, Jackson, MS 39216-4500
- **Phone:** (601) 984-1000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** State Of Mississippi - University Of Mississippi Medical Center (NPI 1154317527, Jackson, MS), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Mississippi School Of Medicine, class of 2021
## Record status
- **NPPES last updated:** July 11, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1801474549) · Data from the CMS NPPES public registry.