Active NPI
Ashtyn Livermore, PA-C
- Physician Assistant
- Fort Wayne, IN
National Provider Identifier
1730009366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601013902
- Practice address
- 12817 Parkview Plaza Dr
Fort Wayne, IN 46845-1741 - Phone
- (269) 275-1410
- NPI assigned
- Jul 15, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601013902 | MI | Primary |
Addresses
Primary practice location
12817 Parkview Plaza Dr
Fort Wayne, IN 46845-1741
Mailing address
12817 Parkview Plaza Dr
Fort Wayne, IN 46845-1741
Phone (269) 275-1410
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784073600000",
"number": "1730009366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12817 PARKVIEW PLAZA DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451741",
"telephone_number": "269-275-1410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12817 PARKVIEW PLAZA DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451741",
"telephone_number": "269-275-1410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIVERMORE",
"first_name": "ASHTYN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-07-15",
"last_updated": "2026-07-15",
"certification_date": "2026-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601013902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.