Hannah Gray, FNP
Individual provider Active NPI Family Nurse Practitioner · De Kalb, MS
NPI 1669889457 · NPPES record last updated Apr 17, 2025
Key facts
- NPI
- 1669889457
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R882611 (MS)
- Practice address
- 201 Birch St
De Kalb, MS 39328-8017 - Phone
- (601) 743-2643
- Fax
- (601) 553-8175
- NPI assigned
- Jul 14, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 19
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MS, AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140923000719 | MS | Practitioner - Nurse Practitioner | 3870712946 | Reassigns benefits to 7 organizations |
| I20191008001693 | AL | Practitioner - Nurse Practitioner | 3870712946 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R882611 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Services of Meridian, Inc. | Current |
Accepting new patients | |
| Scott Regional Medical Center, Inc | Family | Current | Accepting new patients |
| Rush Medical Foundation | Current | Accepting new patients | |
| Medical Foundation, Inc. | Current |
Accepting new patients | |
| Kemper, Cah, Inc. | Current |
Accepting new patients | |
| Kemper, Cah, Inc | Current |
Accepting new patients | |
| Laird Hospital, Inc. | Current | Accepting new patients | |
| Scott Regional Medical Center, Inc. | Family | Current |
Accepting new patients |
| Scott Regional Medical Center, Inc. | Family | Current |
Accepting new patients |
| Laird Hospital, Inc. | Current |
Accepting new patients | |
| Rush Medical Foundation | Current |
Accepting new patients | |
| Anderson Physician Alliance, Inc. | Current |
Accepting new patients | |
| Kemper Cah, Inc. | Current | Accepting new patients | |
| Kemper Cah, Inc | Current |
Accepting new patients | |
| Urology Clinic of Meridian, P.a. | Current | Accepting new patients | |
| Medical Foundation, Inc. | Current |
Accepting new patients | |
| Rush Medical Foundation | Current |
Accepting new patients | |
| Laird Hospital, Inc. | Family | Current |
Accepting new patients |
| Rush Medical Foundation | Past | Accepting new patients |
Locations
1221 N Washington St
Livingston, AL 35470
Phone (205) 652-7680
9097 Collinsville Rd
Collinsville, MS 39325
Phone (601) 626-8874
14365 Highway 16 W
De Kalb, MS 39328
Phone (769) 486-1000
24489 Highway 80
Lake, MS 39092
Phone (601) 775-3264
5334 Dale Dr
Marion, MS 39342
Phone (601) 703-0130
2401 16th St
Meridian, MS 39301
Phone (601) 482-4181
1514 23rd Ave
Meridian, MS 39301
Phone (601) 531-3969
1600 22nd Ave
Meridian, MS 39301
Phone (601) 483-5322
1314 19th Ave
Meridian, MS 39301
Phone (601) 483-0011
2124 14th St
Meridian, MS 39301
Phone (601) 483-8811
317 Highway 13 S
Morton, MS 39117
Phone (601) 732-6301
1106 Central Dr
Philadelphia, MS 39350
Phone (601) 650-9664
603 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-2123
605 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-6925
25117 Highway 15
Union, MS 39365
Phone (601) 774-8214
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R882611 | MS | Yes |
Addresses
Primary practice location
201 Birch St
De Kalb, MS 39328-8017
Mailing address
2701 Davis St
Meridian, MS 39301-5708
Phone (601) 693-0118
Other practice location 1
2124 14th St
Meridian, MS 39301-4040
Phone (601) 553-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03486259 | Medicaid | MS |
Other providers in De Kalb, MS
- William Martin Bracken
- Patricia Dunlap
- Latorie Dunn-King
- Father of Waters Emergency Physicians LLC
- Brandon Nicholas Goza
- Greater Meridian Health Clinic, Inc.
- Anna Marie Hailey-Sharp
- Happy at Home Personal Care Services
- Robert D Hearn Sr.
- Totsseta Hearn
All providers in De Kalb, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.