NPIMap

Individual provider Active NPI

Dalton L Gray II, M.D.

  • Family Medicine Physician
  • Fayetteville, AR
National Provider Identifier
1033283155
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C-6610 Issued in AR
Practice address
3 E Appleby Rd
Suite 101
Fayetteville, AR 72703
Phone
(479) 404-1010
Fax
(479) 404-1011
NPI assigned
Nov 20, 2006
Last updated
Aug 28, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C-6610 AR
Family Medicine Physician 207Q00000X C-6610 AR Primary

Addresses

Primary practice location

3 E Appleby Rd
Suite 101
Fayetteville, AR 72703

Mailing address

PO Box 550
Lowell, AR 72745-0550
Phone (479) 463-7775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050630001173 AR Practitioner - Family Practice 1153367909 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2301 W Pleasant Grove Rd
Suite 101
Rogers, AR 72758-7034
Phone (479) 326-8525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C-6610ARMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System Family Medicine Current Accepting new patients
Washington Regional Medical System CurrentSince Sep 15, 2017 Accepting new patients
BHG L, LLC CurrentSince Feb 1, 2020 Accepting new patients
BHG L, LLC CurrentSince Feb 1, 2020 Accepting new patients
BHG L, LLC Current Accepting new patients
BHG L, LLC Past Accepting new patients
BHG L, LLC Past Accepting new patients
BHG L, LLC Past Accepting new patients
Washington Regional Medical System Past Accepting new patients
BHG L, LLC Past Accepting new patients
BHG L, LLC Past Accepting new patients
Washington Regional Medical System Past Accepting new patients
Arkansas Gatewood Emergency Room Services, PA Emergency Medicine Past Accepting new patients

Locations

255 E College St
Batesville, AR 72501
Phone (870) 569-9862

1058 Front St
Ste 104
Conway, AR 72032
Phone (501) 504-2092

3 E Appleby Rd
Ste 101
Fayetteville, AR 72703
Phone (479) 404-1010

82 W Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 282-2992

1501 S Waldron Rd
Ste 203
Fort Smith, AR 72903
Phone (479) 769-2880

1 Mercy Ln
Ste 403
Hot Springs National Park, AR 71913
Phone (501) 319-7963

5510 Southwest Dr
Ste 8
Jonesboro, AR 72404
Phone (870) 520-6313

2231 Trinity Blvd
Texarkana, AR 71854
Phone (870) 330-3210

5001 Spring Vly
Ste 600E
Dallas, TX 75244

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1033283155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450550",
            "telephone_number": "479-463-7775",
            "fax_number": "479-468-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 E APPLEBY RD",
            "address_2": "SUITE 101",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-404-1010",
            "fax_number": "479-404-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "DALTON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "C-6610",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C-6610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.