KELLY A. LIVELY (P.T.) – Physical Therapist, NPI 1417119249

KELLY A. LIVELY (P.T.) is a healthcare provider. based in Cranston, Rhode Island. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials P.T.. They hold a License No. PT00693 (RI). The NPI Number for KELLY A. LIVELY (P.T.) is 1417119249

Main info

Female
Sole Proprietor
30 Years Of Experience
Accepts Medicare Assignment
Name
KELLY A. LIVELY (P.T.)
NPI
1417119249
Phone
(401) 785-1016
Address
PO BOX 20372
Enumeration Date
2 July 2008
Last Update Date
2 July 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8022532273
Graduation Year
1996 (30 years ago)
PAC ID
6204909096
Group Practice PAC ID
8628168317
Professional Enrollment ID
I20220107002117
Address ID
VT056724775ST1878XRDXX304
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

606 PHYSICAL THERAPIST IN PRIVATE PRACTICE in RI

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Provider Addresses for KELLY A. LIVELY (P.T.)

  • PO BOX 20372

    CRANSTON, RI 029200944

    Phone: (401) 785-1016

    Fax: (401) 785-1018

    Type: Mailing

  • Hope Street, Bristol, Bristol County, Rhode Island, 02809, United States

    BRISTOL, RI 028091126

    Phone: (401) 254-1105

    Fax: (401) 254-1026

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-01-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220107002117IPhysical Therapist In Private PracticeVTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes33640$0
97140Therapy procedure using manual technique, each 15 minutes32639$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes31137$0
97161Evaluation for physical therapy, typically 20 minutes3629$0
View full utilization report →

Insurance plans in this area (ZIP 02920)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8628168317View full group profile
NameSpecialtyState
-VT
Physical Therapist In Private PracticeVT
Physical Therapist In Private PracticeVT
Physical Therapist In Private PracticeVT

Reviews

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Frequently asked questions

How do I look up KELLY A. LIVELY (P.T.) by NPI?
Use NPI 1417119249 when you need to reference KELLY A. LIVELY (P.T.) in forms, claims, or directories.
Is KELLY A. LIVELY (P.T.) active in the national directory?
KELLY A. LIVELY (P.T.)'s public NPI profile is in an active state.
What kind of provider is KELLY A. LIVELY (P.T.)?
The page reflects Physical Therapist for KELLY A. LIVELY (P.T.). Clinical services aligned with this taxonomy classification.
Where is KELLY A. LIVELY (P.T.)'s primary listing?
We display Cranston, Rhode Island because that is what the record indicates for KELLY A. LIVELY (P.T.).
What if Cranston, Rhode Island seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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