NPIMap

Organization Active NPI

Blessing Hospital

Doing business as Hannibal Hospitalist Group

  • Hospitalist Physician
  • Hannibal, MO
National Provider Identifier
1043724875
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
0000141 Issued in IL
Legal business name
BLESSING HOSPITAL
Doing business as
Hannibal Hospitalist Group
Practice address
6000 Hospital Dr
Hannibal, MO 63401-6887
Phone
(573) 248-1300
NPI assigned
Dec 1, 2017
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Timothy A Moore
Title
VP Finance Cao Blessing Corporate
Phone
(217) 223-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X 0000141 IL Primary

Addresses

Primary practice location

6000 Hospital Dr
Hannibal, MO 63401-6887

Mailing address

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

Other names 1

  • Hannibal Hospitalist Group Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171221000766 MO Part B Supplier - Clinic/Group Practice 3072422534 Receives reassigned benefits from 195 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Palmyra, MO; Monroe City, MO; Memphis, MO; Louisiana, MO; La Grange, MO; Kirksville, MO; Hannibal, MO; Kahoka, MO…

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Blessing Hosp Eeg35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Ownership & related parties

Subparts reporting this organization as parent 11

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1512086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1043724875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016887",
            "telephone_number": "573-248-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLESSING HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-03-06",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP FINANCE CAO BLESSING CORPORATE",
        "authorized_official_telephone_number": "217-223-8400"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "0000141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Hannibal Hospitalist Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hannibal Hospitalist Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hannibal, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.