Kelly G Sullivan

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

KY-R2746 Issued in KY

Practice address

444 W Kenwood Dr
Louisville, KY 40214-2859

Phone

(502) 396-1472

NPI assigned

Jan 11, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kelly G Schneider Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sullivan Pediatric Therapy LLC

  • Early Intervention Provider Agency
  • Louisville, KY
  • NPI 1346757663
  NPD Authorized official
• Kelly Sullivan, Otr

  • Early Intervention Provider Agency
  • Louisville, KY
  • NPI 1932475712
  NPD (past) Authorized official
• Professional Evaluation and Developmental Services

  • Speech-Language Pathologist
  • Louisville, KY
  • NPI 1760500508
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588896000000",
    "number": "1144370065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 W KENWOOD DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402142859",
            "telephone_number": "502-396-1472",
            "fax_number": "888-456-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 W KENWOOD DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402142859",
            "telephone_number": "502-396-1472"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "918 Ormsby Ln",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402424536",
            "country_code": "US",
            "telephone_number": "502-327-0045",
            "fax_number": "502-327-0019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KELLY",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "KY",
            "license": "KY-R2746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "SCHNEIDER",
            "middle_name": "G",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Sullivan
• Joeli Rae Sullivan
• John F. Sullivan, MD
• John Paul Sullivan, M.D.
• Kaitlin Sullivan, PA-C
• Kimberly Sullivan, LCSW
• Mark F Sullivan, OD
• Meghan Sullivan, APRN
• Melissa Sullivan, MD
• Misty Sullivan, M.ED

• Pediatric Occupational Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Pediatric Occupational Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.