Kimberly Sullivan

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

901122 Issued in NE

Practice address

17809 Pierce PLZ
Children'S Rehab - Physical Therapy
Omaha, NE 68130-1035

Phone

(402) 955-8355

Fax

(402) 955-8356

NPI assigned

Jun 23, 2016

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

• Kimberly Walz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Children'S Specialty Physician Billing

  • Pediatric Nurse Practitioner
  • Omaha, NE
  • NPI 1013040369
  NPD (past)
• Nebraska Pediatric Practice, Inc

  • Pediatrics Physician
  • Omaha, NE
  • NPI 1144556333
  NPD (past)

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1184075806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 DODGE ST",
            "address_2": "CHILDREN'S HOSPITAL & MEDICAL CENTER",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144113",
            "telephone_number": "402-955-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17809 PIERCE PLZ",
            "address_2": "CHILDREN'S REHAB - PHYSICAL THERAPY",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681301035",
            "telephone_number": "402-955-8355",
            "fax_number": "402-955-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NE",
            "license": "901122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WALZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessie Thomas Sullivan, MD
• Joseph Vincent Sullivan, D.D.S.
• Joyceanna Sullivan
• Kairi Sullivan
• Keegan Sullivan
• Lakaisha Sullivan
• Leanne Sullivan
• Monica A. Sullivan, PA-C
• Nevaeh Sullivan
• Nichole Sullivan

• Pediatric Occupational Therapist in Omaha, NE
• Providers in Omaha, NE by specialty
• Pediatric Occupational Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.

Verify at the official NPI Registry.