DR. KEVIN JOHN KELLERMAN D.M.D.
NPI 1962419317
Dentist - General Practice in Glen Carbon, IL

Q: What is Kevin Kellerman's NPI number?

The NPI number for Kevin Kellerman is 1962419317. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Q: What is Kevin Kellerman'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 Kevin Kellerman was last updated on May 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 01, 2006PECOS Enrolled

16 JUNCTION DR W, SUITE 101, GLEN CARBON, IL 62034(618) 228-3100(618) 288-3434 Get Directions Write a Review

NPPES record last updated: May 13, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 13, 2021, Dec 4, 2020, Nov 20, 2020 and 1 more (4 updates tracked since 2020).

On this page

About Dr. Kevin John Kellerman D.m.d. NPPES

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

DR. KEVIN JOHN KELLERMAN D.M.D. (NPI 1962419317) is an individual general practice provider in Glen Carbon, Illinois, licensed in Illinois (019-025862) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962419317

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. KEVIN JOHN KELLERMANCredential: D.M.D.

Location Address16 JUNCTION DR W, SUITE 101Glen Carbon, IL 62034-2996

Mailing Address16 Junction Dr W, Suite 101Glen Carbon, IL 62034-2996 · (618) 228-3100 · Fax (618) 288-3434

Phone(618) 228-3100

Fax(618) 288-3434

Sole ProprietorNo

Enumeration DateAugust 1, 2006

Last NPPES UpdateMay 13, 20214 updates tracked since enumeration

NPPES CertifiedMay 13, 2021

✔ NPI 1962419317 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in IL · 019-025862

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.

16 JUNCTION DR W, Glen Carbon, IL 62034

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Other Identifiers 1

Medicaid108441IL

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. Kevin John Kellerman D.m.d. 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 62034 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

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$70.42 typical visit price

range $17.51 – $139.99

Typical copayment $17.60 (range $4.37 – $34.99)

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.

Other Providers at the Same Location NPPES

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

PAULA H POST LCPC

Counselor (Professional)

16 JUNCTION DR W
GLEN CARBON, IL 62034

Madison County (618) 288-5019

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Kellerman's NPI number?

The NPI number for Kevin Kellerman is 1962419317. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Where is Kevin Kellerman located?

Kevin Kellerman practices at 16 Junction Dr W Suite 101, Glen Carbon, IL 62034. The listed phone number is (618) 228-3100.

What is Kevin Kellerman's specialty?

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

Is Kevin Kellerman enrolled in Medicare?

Yes. Kevin Kellerman is registered in the Medicare PECOS enrollment system.

What insurance does Kevin Kellerman accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and HRI Dental & Vision and 3 other insurers list Kevin Kellerman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kevin Kellerman was last updated on May 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.