Kiley Lavetta Sullivan, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

46TR01261100 Issued in NJ

Practice address

496 Kings Hwy N Ste 110
Cherry Hill, NJ 08034-1002

Phone

(856) 438-5633

NPI assigned

Dec 2, 2025

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

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ipta Clinical, LLCGroup PAC ID 0749456119, 126 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Ipta Clinical, LLC

  • Physical Therapy Clinic/Center
  • Medford, NJ
  • NPI 1760764484
  Medicare reassignment Care Compare group NPD
• 3 Dimensional Physical Therapy - Pelvic Health LLC

  • Physical Therapist
  • Medford, NJ
  • NPI 1275348500
  NPD (past)

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

{
    "created_epoch": "1764633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1902768427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 KINGS HWY N STE 110",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341002",
            "telephone_number": "856-438-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 KINGS HWY N STE 110",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341002",
            "telephone_number": "856-438-5633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KILEY",
        "middle_name": "LAVETTA",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR01261100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Subspecialty Radiology Inc
• Kelly Suessegger
• Theresa M Sullivan-Steitz, PT
• Jeremy James Sullivan, MPT
• Kelly A Sullivan, OT
• Michael F Sullivan, DMD
• Patrick O. Sullivan, D.O.
• Ibrahim Sultan, M.D.
• Eloise Jamison Sulzman, MSW
• James M. Sumerson, M.D.

• Occupational Therapist in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.