Individual provider Active NPI

Ranae B. Ray, NP

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1891531661
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71015448A Issued in IN
Practice address
7900 W Jefferson Blvd Ste 306
Fort Wayne, IN 46804-4128
Phone
(260) 458-3610
Fax
(260) 458-3611
NPI assigned
Jul 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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 71015448A IN Primary

Addresses

Primary practice location

7900 W Jefferson Blvd Ste 306
Fort Wayne, IN 46804-4128

Mailing address

6920 Pointe Inverness Way Ste 200
Fort Wayne, IN 46804-7934
Phone (260) 479-3514

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
I20240807002130 IN Practitioner - Nurse Practitioner 1951848050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

7900 W Jefferson Blvd
Suite 306
Fort Wayne, IN 46804-4128
Phone (260) 458-3610

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Medical Group LLC CurrentSince Jul 31, 2024 Accepting new patients
Lutheran Medical Group LLC CurrentSince Jul 31, 2024 Accepting new patients

Locations

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

7910 W Jefferson Blvd
Ste 112
Fort Wayne, IN 46804
Phone (260) 969-7121

7952 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 435-2999

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

7900 W Jefferson Blvd
Ste 306
Fort Wayne, IN 46804
Phone (260) 458-3610

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

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 and National Provider Directory roles.

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": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1891531661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 W JEFFERSON BLVD STE 306",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044128",
            "telephone_number": "260-458-3610",
            "fax_number": "260-458-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "RANAE",
        "middle_name": "B.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015448A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.