Individual provider Active NPI

Jennifer Renee Crayne, FNP-C

  • Family Nurse Practitioner
  • Valparaiso, IN
National Provider Identifier
1447822028
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28209566A Issued in IN
Practice address
2307 Laporte Ave Ste 8
Valparaiso, IN 46383-6997
Phone
(219) 464-7073
Fax
(219) 464-7543
NPI assigned
Jul 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28209566A IN Primary

Addresses

Primary practice location

2307 Laporte Ave Ste 8
Valparaiso, IN 46383-6997

Mailing address

PO Box 781076
Detroit, MI 48278-1008
Phone (317) 528-4800

Other practice location 1

3630 Willowcreek Rd
Portage, IN 46368-5075
Phone (219) 364-3900

Other practice location 2

809 LaPorte Ave
Valparaiso, IN 46383-5801
Phone (219) 263-4977

Other practice location 3

650 Dickinson Rd
Chesterton, IN 46304-3387
Phone (219) 926-7755

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
I20210920001260 IN Practitioner - Nurse Practitioner 6204233174 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.68 of 100Reported as apm
Quality
76.2
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28209566AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
La Porte Clinic Company LLC CurrentSince Sep 15, 2022 Accepting new patients
La Porte Clinic Company LLC CurrentSince Sep 15, 2022 Accepting new patients

Locations

104 E Culver Rd
Ste 105
Knox, IN 46534
Phone (574) 772-7300

3630 Willowcreek Rd
Portage, IN 46368
Phone (219) 364-3000

Interoperability endpoints

  • Direct secure messaging: jennifer.crayne.1@24966.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1447822028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781008",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 LAPORTE AVE STE 8",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463836997",
            "telephone_number": "219-464-7073",
            "fax_number": "219-464-7543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3630 Willowcreek Rd",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "IN",
            "postal_code": "463685075",
            "country_code": "US",
            "telephone_number": "219-364-3900",
            "fax_number": "219-364-3959",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "809 LaPorte Ave",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463835801",
            "country_code": "US",
            "telephone_number": "219-263-4977",
            "fax_number": "219-263-4979",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 Dickinson Rd",
            "address_purpose": "LOCATION",
            "city": "Chesterton",
            "state": "IN",
            "postal_code": "463043387",
            "country_code": "US",
            "telephone_number": "219-926-7755",
            "fax_number": "219-929-1885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAYNE",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28209566A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

Verify at the official NPI Registry.