Amber Marie Kellerman, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209021588 Issued in IL

Practice address

5383 State Route 154
Pinckneyville, IL 62274-3342

Phone

(618) 357-2187

NPI assigned

Jul 13, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinckneyville Community HospitalGroup PAC ID 8123921632, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• At Home Health Care Home health agency, Sparta, IL, CCN 147694
• Pinckneyville Community Hospital Hospital, Pinckneyville, IL, CCN 141307
• Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
• Marshall Browning Hospital Hospital, Du Quoin, IL, CCN 141331

Merit-based Incentive Payment System (MIPS)

Final score

91.05 of 100Reported as apm

Quality

72.1

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: akellerman@direct.pvillehosp.org

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.

• Pinckneyville Community Hospital

  • Critical Access Hospital
  • Pinckneyville, IL
  • NPI 1689646523
  Medicare reassignment Care Compare group NPD
• Pinckneyville Community Hospital

  • Rural Health Clinic/Center
  • Pinckneyville, IL
  • NPI 1306818844
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Marshall Browning Hospital Association

  • Critical Access Hospital
  • Du Quoin, IL
  • NPI 1821099441
  Care Compare affiliation
• Pinckneyville Community Hospital

  • Critical Access Hospital
  • Pinckneyville, IL
  • NPI 1689646523
  Care Compare affiliation
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Carbondale, IL
  • NPI 1093801797
  Care Compare affiliation
• Sparta Community Hospital

  • Home Health Agency
  • Sparta, IL
  • NPI 1639187149
  Care Compare affiliation

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1689292997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5383 STATE ROUTE 154",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622743342",
            "telephone_number": "618-357-2187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5383 STATE ROUTE 154",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622743342",
            "telephone_number": "618-357-2187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLERMAN",
        "first_name": "AMBER",
        "middle_name": "MARIE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209021588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akellerman@direct.pvillehosp.org",
            "affiliation": "N",
            "endpointDescription": "Family Medical Center",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "TOC, Clinical Summary, CCD",
            "address_1": "5383 State Route 154",
            "city": "Pinckneyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622743342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Crystal Jean Hillyard, P.T.
• Monica Hitchens
• Leah M. Hopp, NP
• Pamela Sue Jackson, LCSW
• Terry Lewis Jackson, LCPC
• Janelle Kellerman, LSW
• Janet Marie Kitchen, RPH
• Kimberly Dawn Kreid, PT
• Chelsea M. Kuhnert
• Manor at Mason Woods

• Family Nurse Practitioner in Pinckneyville, IL
• Providers in Pinckneyville, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.