Individual provider Active NPI

Derrick Andre Gray, M.D.

  • Family Medicine Physician
  • Springdale, AR
National Provider Identifier
1609073022
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E6424 Issued in AR
Practice address
2422 N Thompson St
Springdale, AR 72764-1757
Phone
(479) 750-6585
Fax
(479) 750-6594
NPI assigned
Jun 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E6424 AR Primary

Addresses

Primary practice location

2422 N Thompson St
Springdale, AR 72764-1757

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Other practice location 1

1125 N College Ave
Fayetteville, AR 72703-1908
Phone (479) 521-8260

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100625000800 AR Practitioner - Family Practice 1456482074 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sebastian Physician Services, PLLCGroup PAC ID 5294178448, 41 clinicians
University of Arkansas for Medical SciencesGroup PAC ID 4082528955, shared by 29 NPIs, 1,159 clinicians
Springdale Bentonville HBP Services LLCGroup PAC ID 1052759263, 88 clinicians

Practice addresses (Care Compare)

1001 Towson Ave
Fort Smith, AR 72901-4921
Phone (479) 441-4000

1125 N College Ave
Fayetteville, AR 72703-1908
Phone (479) 521-8260

3000 Medical Ctr Pkwy
Bentonville, AR 72712-3217
Phone (479) 553-1000

4301 W Markam St
Little Rock, AR 72205-7101

601 W Maple Ave
Springdale, AR 72764-5370
Phone (479) 750-6585

7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone (479) 314-5175

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Current Accepting new patients
Crawford Physician Services, PLLC CurrentSince Oct 1, 2024 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Dec 20, 2021 Accepting new patients
Ies HSP Arkansas PLLC CurrentSince May 28, 2023 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Dec 20, 2021 Accepting new patients
University of Arkansas for Medical Sciences Family Medicine CurrentSince Jul 1, 2010 Accepting new patients
Arkansas Post Discharge Services, PLLC CurrentSince Mar 15, 2024 Accepting new patients
Sebastian Physician Services, PLLC CurrentSince Mar 19, 2024 Accepting new patients
University of Arkansas for Medical Sciences Family Medicine CurrentSince Jul 1, 2010 Accepting new patients
University of Arkansas for Medical Sciences Family Medicine CurrentSince Jul 1, 2010 Accepting new patients
Springdale- Bentonville HBP Services, LLC CurrentSince Apr 30, 2024 Accepting new patients
WH Ar Medical PLLC Family Medicine Past Accepting new patients
Baptist Health Regional Hospitals Past Accepting new patients

Locations

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

3873 N Parkview Dr
Fayetteville, AR 72703
Phone (479) 527-0050

1125 N College Ave
Fayetteville, AR 72703
Phone (479) 521-8260

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

601 W Maple Ave
Ste 102
Springdale, AR 72764
Phone (479) 750-6585

211 Crawford Memorial Dr
Van Buren, AR 72956
Phone (479) 471-4300

Interoperability endpoints

  • Direct secure messaging: dgray46811@washingtonregional.direct-ci.com

Organizations & group practices 13

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 13

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1609073022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000",
            "fax_number": "501-526-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 N THOMPSON ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727641757",
            "telephone_number": "479-750-6585",
            "fax_number": "479-750-6594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 N College Ave",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727031908",
            "country_code": "US",
            "telephone_number": "479-521-8260",
            "fax_number": "479-443-3903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "DERRICK",
        "middle_name": "ANDRE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E6424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.