Individual provider Active NPI

Deanna L. Rodenberg, NP

  • Nurse Practitioner
  • Belleville, IL
National Provider Identifier
1013265248
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209009887 Issued in IL
Practice address
4550 Memorial Dr
Ste. 340
Belleville, IL 62226-5372
Phone
(618) 257-6200
Fax
(618) 257-6679
NPI assigned
Aug 20, 2012
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2012025805 MO
Registered Nurse 163W00000X 041404382 IL
Nurse Practitioner 363L00000X 209009887 IL Primary

Addresses

Primary practice location

4550 Memorial Dr
Ste. 340
Belleville, IL 62226-5372

Mailing address

4550 Memorial Dr
Ste. 340
Belleville, IL 62226-5372
Phone (618) 257-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130208000102 IL Practitioner - Nurse Practitioner 0446404982 Reassigns benefits to 3 organizations
I20130816000786 MO Practitioner - Nurse Practitioner 0446404982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Saint Anthonys Way
Alton, IL 62002-4568
Phone (618) 465-2571

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

12866 Troxler Ave
Highland, IL 62249-2806
Phone (618) 651-2658

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.63
Improvement activities
40
Cost
81.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041404382ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Illinois SNF LLP CurrentSince Oct 1, 2016 Accepting new patients
Cep America - Illinois SNF, LLP Current Accepting new patients
Cep America Illinois Intensivists CurrentSince Feb 1, 2017 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Oct 31, 2019 Accepting new patients
Cep America Illinois Intensivists CurrentSince Feb 1, 2017 Accepting new patients
Galen Inpatient Physicians PC. CurrentSince Oct 31, 2019 Accepting new patients
Cep America-Illinois Hospitalists CurrentSince Apr 1, 2014 Accepting new patients
Cep America Illinois Intensivists Current Accepting new patients
Cep America-Illinois Hospitalists, LLP CurrentSince Apr 1, 2014 Accepting new patients
Cep America - Illinois SNF, LLP CurrentSince Oct 1, 2016 Accepting new patients
PC Associates LLC Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

200 Health Care Dr
Greenville, IL 62246
Phone (618) 664-0808

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1013265248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR",
            "address_2": "STE. 340",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265372",
            "telephone_number": "618-257-6200",
            "fax_number": "618-257-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR",
            "address_2": "STE. 340",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265372",
            "telephone_number": "618-257-6200",
            "fax_number": "618-257-6679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODENBERG",
        "first_name": "DEANNA",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-20",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012025805",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041404382",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209009887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.