Individual provider Active NPI

Debra J Connell-Dent, APN

  • Nurse Practitioner
  • Florissant, MO
National Provider Identifier
1558904508
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2019024738 Issued in MO
Practice address
1225 Graham Rd Ste C-2320
Florissant, MO 63031-8030
Phone
(314) 953-6801
NPI assigned
Oct 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2019024738 MO Primary
Family Nurse Practitioner 363LF0000X 209019906 IL

Addresses

Primary practice location

1225 Graham Rd Ste C-2320
Florissant, MO 63031-8030

Mailing address

1225 Graham Rd Ste C-2320
Florissant, MO 63031-8030
Phone (314) 953-6801

Other practice location 1

50 Northgate Industrial Dr
Granite City, IL 62040-6805
Phone (618) 877-4420

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20200331000957 IL Practitioner - Nurse Practitioner 1153750997 Reassigns benefits to 1 organization
I20221230001325 MO Practitioner - Nurse Practitioner 1153750997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

1225 Graham Rd
Suite C 2320
Florissant, MO 63031-8030
Phone (314) 953-6801

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209019906ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Health Systems Inc CurrentSince Feb 24, 2020 Accepting new patients
Physician Groups LC CurrentSince Jan 15, 2023 Accepting new patients
Physician Groups LC CurrentSince Jan 15, 2023 Accepting new patients
Chestnut Health Systems Inc. CurrentSince Feb 24, 2020 Accepting new patients

Locations

1003 Martin Luther King Dr
Bloomington, IL 61701
Phone (309) 827-6026

702 W Chestnut St
Bloomington, IL 61701
Phone (309) 557-1400

50 Northgate Industrial Dr
Granite City, IL 62040
Phone (618) 512-1919

448 Wylie Dr
Normal, IL 61761
Phone (844) 973-6887

1225 Graham Rd
Ste C-2320
Florissant, MO 63031
Phone (314) 953-6801

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1558904508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 GRAHAM RD STE C-2320",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318030",
            "telephone_number": "314-953-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 GRAHAM RD STE C-2320",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318030",
            "telephone_number": "314-953-6801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Northgate Industrial Dr",
            "address_purpose": "LOCATION",
            "city": "Granite City",
            "state": "IL",
            "postal_code": "620406805",
            "country_code": "US",
            "telephone_number": "618-877-4420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELL-DENT",
        "first_name": "DEBRA",
        "middle_name": "J",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2019024738",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209019906",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1225 Graham Rd Ste C-2320",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630318030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

Verify at the official NPI Registry.