Kenneth Shively, M.D.
Individual
Deactivated
NPI 1932183449
Family Medicine Physician
Laporte, IN
Kenneth Shively, M.D. holds NPI 1932183449, with a primary taxonomy of family medicine physician and a practice location in Laporte, IN. The number was issued on November 30, 2005 and the NPPES record was last updated on August 2, 2026. This NPI was deactivated on September 17, 2026.
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician Primary | 207Q00000X | 01024055A (IN) |
Practice location
Other providers at this address
- Heather Hazel, MD (Family Medicine Physician)
Providers whose NPPES practice location has the same street address, listing those with a page here.
Nearby providers with the same primary taxonomy
- Heather Hazel, MD , La Porte, IN, same ZIP code
- James Callaghan, M.D. , Michigan City, IN, about 11 miles
- Jeffrey Seizys, M.D. , Long Beach, IN, about 11 miles
- Natalie Opanasets, M.D. , Michigan City, IN, about 11 miles
- Alexander Molina, M.D. , Chesterton, IN, about 18 miles
- Gary Babcoke, MD , Chesterton, IN, about 18 miles
- Bharat Pithadia, MD , Valparaiso, IN, about 21 miles
- Derek Gasper, D.O , Valparaiso, IN, about 21 miles
Record history
- Name on record
- Dr. Kenneth Daniel Shively
- Status
- Deactivated
- NPI issued
- Last updated in NPPES
- Deactivated
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NPPES data as of · Source: CMS NPPES
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