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

Logan Andrew Shively, PA

Individual provider Physician Assistant · NPI 1558907717

Logan Andrew Shively, PA is a Physician Assistant in Cincinnati, Ohio. Licensed in Ohio. Registered with an NPI since 2019.

Licensed in
OH
In the registry since
2019
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone: (513) 792-7445
Fax: (513) 791-4042
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.006704 (OH)

Record details

NPI number1558907717
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 22, 2019
Last updated in NPPESSeptember 20, 2022
Certification dateSeptember 20, 2022

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