Russell Wayne Gray, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

901751 Issued in MS

Practice address

5001 Hardy St
Hattiesburg, MS 39402-1308

Phone

(601) 319-5647

NPI assigned

Dec 30, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Lifelinc Anesthesia PLLCGroup PAC ID 0941347447, 169 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Merit Health Wesley Hospital, Hattiesburg, MS, CCN 250094
• Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment Care Compare group NPD
• Lifelinc Anesthesia, PLLC

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1801021464

  MS, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Hattiesburg Clinic, PA

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  Care Compare affiliation
• Wesley Health System LLC

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1841241841
  Care Compare affiliation

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1215697388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 E CROCKETT DR",
            "city": "SUMRALL",
            "state": "MS",
            "postal_code": "394825062",
            "telephone_number": "601-319-5647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 HARDY ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021308",
            "telephone_number": "601-319-5647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 S 28th Ave",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394017246",
            "country_code": "US",
            "telephone_number": "601-261-3606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "RUSSELL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-30",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "901751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Portia M Granger, LCSW
• Tyler Graves, DO
• Lynjaven J Gray
• Marli Malone Gray, DNP, CRNA
• Matilyn Walden Gray
• Brandon Isaac Grayson
• Green Eye Institute PA
• Annie B Green, FNP-BC
• Cierra Celeste Green, M.D.
• Gachavis M Green, D.P.M.

• Certified Registered Nurse Anesthetist in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Certified Registered Nurse Anesthetist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.