Deanna L. Rodenberg, NP
Individual provider Active NPI Nurse Practitioner · Belleville, IL
NPI 1013265248 · NPPES record last updated Feb 8, 2014
Key facts
- NPI
- 1013265248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 209009887 (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
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cep America-Illinois Hospitalists, LLP
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
- HSHS St Elizabeth'S Hospital
- St Joseph'S Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 96.63
- Improvement activities
- 40
- Cost
- 81.81
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130208000102 | IL | Practitioner - Nurse Practitioner | 0446404982 | Reassigns benefits to 3 organizations |
| I20130816000786 | MO | Practitioner - Nurse Practitioner | 0446404982 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041404382 | IL | MD | Registered Nurse |
| 209009887 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - Illinois SNF, LLP | Current |
Accepting new patients | |
| Galen Inpatient Physicians PC. | Current |
Accepting new patients | |
| Cep America - Illinois SNF LLP | Current |
Accepting new patients | |
| Cep America - Illinois SNF, LLP | Current | Accepting new patients | |
| Cep America Illinois Intensivists | Current |
Accepting new patients | |
| Cep America-Illinois Hospitalists, LLP | Current |
Accepting new patients | |
| Cep America-Illinois Hospitalists | Current |
Accepting new patients | |
| Galen Inpatient Physicians PC | Current |
Accepting new patients | |
| Cep America Illinois Intensivists | Current |
Accepting new patients | |
| Cep America Illinois Intensivists | Current | 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) 851-7423
1021 W E St
Belleville, IL 62220
Phone (618) 233-2095
200 Health Care Dr
Greenville, IL 62246
Phone (618) 664-0808
1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438
4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2012025805 | MO | |
| Registered Nurse | 163W00000X | 041404382 | IL | |
| Nurse Practitioner | 363L00000X | 209009887 | IL | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209009887 | Other | IL | APN |
| 041404382 | Other | IL | RN |
Other providers in Belleville, IL
- Robert Hellman MD. LLC
- Maggie Elizabeth Roberts
- Mocha Lee Robinson
- Shalisha Robinson
- Julie Rodemich
- Enrique Rodriguez
- Guillermo Rodriguez Jr.
- Christina Marie Rogers
- Angela Michelle Rohn
- Laequah Rollins
All providers in Belleville, IL · Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.