Blessing Walk-in Clinic LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BLESSING WALK-IN CLINIC LLC

Practice address

3700 Broadway St
Quincy, IL 62305-2822

Phone

(217) 228-1060

NPI assigned

Jan 23, 2018

Last updated

May 12, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

BLESSING WALK-IN CLINIC LLCAs reported in NPPES

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

Authorized official

Name

Maureen Kahn

Title

President, Ceo

Phone

(217) 223-8400

Specialties & licenses 2

Addresses

Electronic endpoints 1

Part of

Blessing Walk in Clinic LLC

Practitioners 1

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.

• Jerry D Kennett, M.D.

  • Cardiovascular Disease Physician
  • Columbia, MO
  • NPI 1851383145
  NPD (past)

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1134627326",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623052822",
            "telephone_number": "217-228-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLESSING WALK-IN CLINIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLESSING WALK-IN CLINIC LLC",
        "enumeration_date": "2018-01-23",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "KAHN",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "217-223-8400"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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",
            "affiliationName": "Cobius Healthcare Solutions",
            "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": []
}

• Blessing Hospital
• Blessing Hospital (Brown Drug Company)
• Blessing Hospital
• Blessing Hospital (Blessing Hospice)
• Blessing Walk-in Clinic LLC (Blessing Convenient Care)
• Blessingcare Corporation (Illini Community Hospital Inpatient Behavioral)
• Brenda Colleen Blickhan, AGNP-C
• Carlene T Blickhan, RN
• Board of Trustees of Southern Illinois University (SIU Center for Family Medicine - Transitions of Western Illinois)
• Board of Trustees of Southern Illinois University

• Family Medicine Physician in Quincy, IL
• Providers in Quincy, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.