Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jordan Tyler Shively, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1194170910

Dr. Jordan Tyler Shively, DO is a General Surgery in Las Vegas, Nevada. Qualified in 2016, 10 years ago. Practices with William Bee Ririe Hospital, a 40-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Nevada and Ohio.

Years since qualifying
10
Licensed in
NV, OH
In the registry since
2016
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Las Vegas, NV

No coordinates on file. Search this address in Google Maps

Additional practice locations (1)

  • 20000 Harvard Ave, Warrensville Heights, OH 44122-6805 — (216) 491-7464

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence DO2821 (NV)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (OH)

Record details

NPI number1194170910
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 29, 2016
Last updated in NPPESJuly 1, 2021
Certification dateJuly 1, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice William Bee Ririe Hospital — 40 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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