NPIMap

Organization Active NPI

Kelly Sullivan, Otr

  • Early Intervention Provider Agency
  • Louisville, KY
National Provider Identifier
1932475712
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
KY-R2746 Issued in KY
Legal business name
KELLY SULLIVAN, OTR
Practice address
444 W Kenwood Dr
Louisville, KY 40214-2859
Phone
(502) 396-1472
NPI assigned
Mar 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Authorized official

Name
Kelly SullivanNPI 1144370065
Title
Owner
Phone
(502) 396-1472

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X KY-R2746 KY Primary

Addresses

Primary practice location

444 W Kenwood Dr
Louisville, KY 40214-2859

Mailing address

444 W Kenwood Dr
Louisville, KY 40214-2859

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1932475712",
    "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"
        },
        {
            "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": [],
    "basic": {
        "organization_name": "KELLY SULLIVAN, OTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-396-1472"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "KY",
            "license": "KY-R2746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.