Individual provider Active NPI

Ashleigh Jenae Detray

  • Nurse Practitioner
  • Bluffton, IN
National Provider Identifier
1073307120
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71017685A Issued in IN
Practice address
1115 S Main St
Bluffton, IN 46714-3616
Phone
(260) 824-1071
Fax
(260) 824-5578
NPI assigned
Apr 5, 2025
Last updated
Feb 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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 71017685A IN Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1115 S Main St
Bluffton, IN 46714-3616

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

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
I20260218001094 IN Practitioner - Nurse Practitioner 6507346590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Center IncGroup PAC ID 5991794794, 47 clinicians

Practice addresses (Care Compare)

1115 S Main St
Bluffton, IN 46714-3616
Phone (260) 824-1071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71017685AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Park Center Inc CurrentSince Feb 11, 2026 Accepting new patients
Park Center Inc CurrentSince Feb 11, 2026 Accepting new patients

Locations

1115 S Main St
Bluffton, IN 46714
Phone (260) 824-1071

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

909 E State Blvd
Fort Wayne, IN 46805
Phone (260) 481-2718

26 Victory Noll Dr
Huntington, IN 46750
Phone (260) 355-3730

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.

NPI Registry JSON

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

{
    "created_epoch": "1743811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1073307120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S MAIN ST",
            "city": "BLUFFTON",
            "state": "IN",
            "postal_code": "467143616",
            "telephone_number": "260-824-1071",
            "fax_number": "260-824-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETRAY",
        "first_name": "ASHLEIGH",
        "middle_name": "JENAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-05",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71017685A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, IN

Sources for this page

Verify at the official NPI Registry.