Sullivan James Kiley, M.S.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

470 Sias Ave
Newport, VT 05855-5872

Phone

(802) 585-3212

NPI assigned

Jul 18, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Sully James Kiley Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1285287342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 248",
            "city": "WATERBURY CENTER",
            "state": "VT",
            "postal_code": "056770248",
            "telephone_number": "541-408-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 SIAS AVE",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058555872",
            "telephone_number": "802-585-3212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "326 SW 7th St",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "977562205",
            "country_code": "US",
            "telephone_number": "802-473-2761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILEY",
        "first_name": "SULLIVAN",
        "middle_name": "JAMES",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-18",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SULLY",
            "last_name": "KILEY",
            "middle_name": "JAMES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Speech-Language Pathologist in Newport, VT
• Providers in Newport, VT by specialty
• Speech-Language Pathologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.