DR. KELLY JO PHILLIPS DDS
NPI 1922167410
Dentist - General Practice in Worthington, MN

Q: What is Kelly Phillips's NPI number?

The NPI number for Kelly Phillips is 1922167410. It was assigned to this individual provider in the NPPES registry on December 8, 2006.

Q: What is Kelly Phillips's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Phillips was last updated on October 15, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 08, 2006PECOS Enrolled

1316 MCMILLAN ST, WORTHINGTON, MN 56187(507) 376-5525(507) 376-3796 Get Directions Write a Review

NPPES record last updated: October 15, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Dr. Kelly Jo Phillips Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KELLY JO PHILLIPS DDS (NPI 1922167410) is an individual general practice provider in Worthington, Minnesota, licensed in Minnesota (D12193) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1922167410

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDR. KELLY JO PHILLIPSCredential: DDS

Location Address1316 MCMILLAN STWorthington, MN 56187-1646

Mailing Address1316 Mcmillan St., Po Box 727Worthington, MN 56187 · (507) 376-5525

Phone(507) 376-5525

Fax(507) 376-3796

Sole ProprietorNo

Enumeration DateDecember 8, 2006

Last NPPES UpdateOctober 15, 2012

✔ NPI 1922167410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in MN · D12193

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1316 MCMILLAN ST, Worthington, MN 56187

Open in Google Maps ↗

Other Identifiers 1

Medicaid687623400MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kelly Jo Phillips Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56187 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Leave this field empty

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JERRY LEE JOHNSON D.D.S

Dentist (General Practice)