Blessing Hospital
Organization Active NPI Rural Health Clinic/Center · Kahoka, MO
NPI 1104512805 · NPPES record last updated May 17, 2023
Key facts
- NPI
- 1104512805
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- BLESSING HOSPITAL
- Practice address
- 103 E Commercial St
Kahoka, MO 63445-1701 - Phone
- (660) 727-3377
- Fax
- (660) 727-3775
- NPI assigned
- Apr 14, 2023
- Organization subpart
- Yes
- Parent organization (as reported)
- BLESSING HOSPITAL
Authorized official
- Name
- Maureen Kahn
- Title
- BCS Ceo
- Phone
- (217) 223-8400
Parent organization (reported in NPPES) 1
Owners & managing parties with NPI records 8
-
Timothi J. Beth, D.O.
-
John H Arnold, M.D.
-
Steven Krause, D.O.
-
Thomas H Miller, M.D.
Other NPIs with the same Medicare PAC ID 20
Corporate family (same tax ID) 34
Member of 1
Related certifications (CCN) 2
Change of ownership 1
Facilities with the same owner 20
Practitioners 414
-
Kamal Akhtar, FNP
-
Michelle Elizabeth Allen, N.P.
-
Pervez A Alvi, M.D.
-
Nikhil Banerjee, M.D.
-
Arif A Bari, M.D.
-
Misty D Bowen, D.O.
-
Carrol Leann Boxerman, D.O.
-
Lauren N. Brandenburger, ACNP-BC
-
Olivia Addison Bross, APRN-FNP-C
-
Penny Elizabeth Buening, APRN
-
Heidi E Craddock, FNP
-
Alyssa Crowe, ACNP
-
Umar Daud, MD
-
Roy A Doerhoff, MD
-
Jeffry T Evans, M.D.
-
Humam W Farah, M D
-
Michelle N Friedersdorf, D.P.M.
-
Scott C Friedersdorf, D.P.M.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D0707926 | Blessing Health Kahoka | Certificate of waiver | Nov 16, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Rural health clinic certification: CCN 268809
- Legal name
- BLESSING HOSPITAL
- Doing business as
- BLESSING HEALTH KAHOKA
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Aug 18, 2024
- Last certification
- Aug 18, 2024
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 29, 1973 in IL
- Enrollment address
- 103 E Commercial St
Kahoka, MO 63445-1701 - Related CCNs
- 140015
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| Thomas Miller |
Corporate Director |
Jan 1, 2013 | |
| Mohamed Ali |
Corporate Director |
Oct 16, 2017 | |
| Benjamin Van Ness |
Corporate Director |
Feb 1, 2022 | |
| Timothi J. Beth |
Corporate Director |
Jan 1, 2022 | |
| Nancy Bluhm |
Corporate Director |
Feb 1, 2017 | |
| Jeannie Goodman |
Corporate Director |
Aug 21, 2023 | |
| Patrick Gerveler |
Corporate Officer |
Apr 1, 2001 | |
| Corporate Director |
Apr 1, 2001 | ||
| Abby Reich |
Corporate Director |
Jan 1, 2013 | |
| John Arnold |
Corporate Director |
Jan 25, 2024 | |
| Blessing Corporate Services, Inc. |
5% Or Greater Direct Ownership Interest | Aug 18, 2024 | 100% |
| Brian Canfield |
Corporate Officer |
Aug 15, 2022 | |
| Corporate Director |
Aug 15, 2022 | ||
| Operational/Managerial Control | Jul 1, 2023 | ||
| Mark Baumann |
Corporate Director |
Jan 25, 2024 | |
| Timothy Koontz |
Corporate Director |
May 8, 2006 | |
| Allison Hall |
Corporate Director |
Jan 25, 2024 | |
| James Rinella |
Corporate Director |
Jan 25, 2024 | |
| Julie Brink |
Corporate Director |
Oct 16, 2017 | |
| Steven Krause |
Corporate Director |
Jan 25, 2024 | |
| Julie Duke |
Corporate Officer |
Dec 1, 2022 |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Aug 18, 2024 | Change of Ownership |
Kahoka Medical Clinic |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241021003778 | MO | Part a Provider - Rural Health Clinic | 3072422534 | Practice locations: Kahoka, MO |
National Provider Directory
- Tax ID family
- Blessing Hosp Cardiolog
- Part of
- Blessing Hosp Cardiolog
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
103 E Commercial St
Kahoka, MO 63445-1701
Mailing address
1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400
Other names
- Blessing Health Kahoka
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Kahoka, MO
- Samantha Allen
- Deana Lynn Ball
- Lynne Barbour
- Blessing Corporate Services, Inc
- Jessica Dianne Boudreau
- Stacia N. Briscoe
- Brittany Thornburg
- Clark County Ambulance District
- Clark County Nursing Home
All providers in Kahoka, MO · Rural Health Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2023. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- 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.