Individual provider Active NPI

Christina Lynn Raynor

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1659086387
Registry record updated Oct 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71014024A Issued in IN
Practice address
10465 E County Road 100 N
Indianapolis, IN 46234-1243
Phone
(757) 754-2600
NPI assigned
Jan 17, 2023
Last updated
Oct 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71014024A IN Primary
Registered Nurse 163W00000X 28251685A IN

Addresses

Primary practice location

10465 E County Road 100 N
Indianapolis, IN 46234-1243

Mailing address

10465 E County Road 100 N
Indianapolis, IN 46234-1243
Phone (317) 926-3739

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
I20230713003495 IN Practitioner - Nurse Practitioner 1557721149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Inc.Group PAC ID 4587604962, 20 clinicians

Practice addresses (Care Compare)

10465 E County Rd 100
Indianapolis, IN 46234-1243
Phone 31792637395155

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Inc CurrentSince Aug 15, 2023 Accepting new patients
Dermatology Inc CurrentSince Aug 15, 2023 Accepting new patients

Locations

875 Airport Pkwy
Greenwood, IN 46143
Phone 31792637395155

10465 E County Road 100 N
Indianapolis, IN 46234
Phone 31792637395155

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698537600000",
    "number": "1659086387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10465 E COUNTY ROAD 100 N",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462341243",
            "telephone_number": "317-926-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10465 E COUNTY ROAD 100 N",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462341243",
            "telephone_number": "757-754-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYNOR",
        "first_name": "CHRISTINA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-10-29",
        "certification_date": "2023-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71014024A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28251685A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.