Individual provider Active NPI

Deanna Roberts

  • Nurse Practitioner
  • Cookeville, TN
National Provider Identifier
1548704547
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
22078 Issued in TN
Practice address
1 Medical Center Blvd
Cookeville, TN 38501-4294
Phone
(931) 783-2770
NPI assigned
Dec 9, 2016
Last updated
Jun 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 22078 TN Primary

Addresses

Primary practice location

1 Medical Center Blvd
Cookeville, TN 38501-4294

Mailing address

1 Medical Center Blvd
Cookeville, TN 38501-4294
Phone (931) 783-2770

Other identifiers 1

IdentifierTypeStateIssuer
Q026777MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20170703000737 TN Practitioner - Nurse Practitioner 9830468057 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cookeville Hospitalist Group PLLCGroup PAC ID 1254794282, 56 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Blvd
Cookeville, TN 38501-4294
Phone (931) 528-2541

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22078TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
App of Tennessee HM, PLLC Nurse Practitioner CurrentSince Jul 1, 2019 Accepting new patients
Cookeville Hospitalist Group, PLLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

106 Medical Center Blvd
Fayetteville, TN 37334
Phone (931) 438-1100

1411 W Baddour Pkwy
Lebanon, TN 37087
Phone (615) 443-2500

2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433

Organizations & group practices 2

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 1

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": "1481241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1548704547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014294",
            "telephone_number": "931-783-2770",
            "fax_number": "615-851-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014294",
            "telephone_number": "931-783-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "DEANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-09",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "22078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q026777",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.