Individual provider Active NPI

Tessa L Ray, FNP-C

  • Family Nurse Practitioner
  • Bedford, IN
National Provider Identifier
1336815794
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71011469A Issued in IN
Practice address
2415 Mitchell Rd Ste C
Bedford, IN 47421-4747
Phone
(812) 393-8070
Fax
(812) 954-5024
NPI assigned
Aug 17, 2021
Last updated
Dec 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 71011469A IN
Family Nurse Practitioner 363LF0000X 71011469A IN Primary

Addresses

Primary practice location

2415 Mitchell Rd Ste C
Bedford, IN 47421-4747

Mailing address

8003 Castleway Dr
Indianapolis, IN 46250-1946
Phone (317) 576-1335

Other practice location 1

120 Saint Louis Ave
Seymour, IN 47274-2304
Phone (812) 405-1857

Other identifiers 1

IdentifierTypeStateIssuer
300055144MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210921000920 IN Practitioner - Nurse Practitioner 7618374570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana Health Centers IncGroup PAC ID 3971599473, 63 clinicians

Practice addresses (Care Compare)

2415 Mitchell Rd
Suite C
Bedford, IN 47421-4747
Phone (812) 393-8070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71011469AINMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Health Centers, Inc. CurrentSince Mar 11, 2025 Accepting new patients
Indiana Health Centers Inc CurrentSince Mar 11, 2025 Accepting new patients
Indiana Health Centers Inc Family Past Accepting new patients
Transitions Recovery, LLC PastSince Aug 1, 2021 Accepting new patients
Indiana Health Centers, Inc. Family Past Accepting new patients

Locations

2415 Mitchell Rd
Ste C
Bedford, IN 47421
Phone (812) 275-2660

8003 Castleway Dr
Indianapolis, IN 46250
Phone (317) 576-1335

120 Saint Louis Ave
Seymour, IN 47274
Phone (812) 405-1857

765 S Michigan St
South Bend, IN 46601
Phone (574) 235-7990

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1336815794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8003 CASTLEWAY DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462501946",
            "telephone_number": "317-576-1335",
            "fax_number": "317-343-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 MITCHELL RD STE C",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474214747",
            "telephone_number": "812-393-8070",
            "fax_number": "812-954-5024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Saint Louis Ave",
            "address_purpose": "LOCATION",
            "city": "Seymour",
            "state": "IN",
            "postal_code": "472742304",
            "country_code": "US",
            "telephone_number": "812-405-1857",
            "fax_number": "812-954-5022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "TESSA",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71011469A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011469A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300055144",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, IN

Sources for this page

Verify at the official NPI Registry.