Active NPI
Trudy Rodenberg, MS,CCC-SLP
- Speech-Language Pathologist
- Macomb, IL
National Provider Identifier
1992810840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146.009091
- Practice address
- 8 Doctors LN
Macomb, IL 61455-3310 - Phone
- (309) 833-5555
- NPI assigned
- Aug 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 7139 | NC | |
| Speech-Language Pathologist | 235Z00000X | 146.009091 | IL | Primary |
Addresses
Primary practice location
8 Doctors LN
Macomb, IL 61455-3310
Mailing address
8 Doctors LN
Macomb, IL 61455-3310
Phone (309) 833-5555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7139 | NC | MD | Mental Health Counselor |
| 146.009091 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209600000000",
"number": "1992810840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 DOCTORS LN",
"city": "MACOMB",
"state": "IL",
"postal_code": "614553310",
"telephone_number": "309-833-5555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 DOCTORS LN",
"city": "MACOMB",
"state": "IL",
"postal_code": "614553310",
"telephone_number": "309-833-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODENBERG",
"first_name": "TRUDY",
"credential": "MS,CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-20",
"last_updated": "2008-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "7139",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146.009091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macomb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.