NPIMap

Organization Active NPI

Blessing Hospital

Doing business as Blessing Health Hannibal

  • Rural Health Clinic/Center
  • Hannibal, MO
National Provider Identifier
1457062101
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BLESSING HOSPITAL
Doing business as
Blessing Health Hannibal
Practice address
100 Medical Dr Ste A1G1H
Hannibal, MO 63401-6877
Phone
(573) 231-3900
Fax
(573) 231-3827
NPI assigned
Dec 13, 2022
Last updated
Nov 7, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
BLESSING HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Authorized official

Name
Brian Canfield
Title
President / Ceo
Phone
(217) 223-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

100 Medical Dr Ste A1G1H
Hannibal, MO 63401-6877

Mailing address

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

Other names 1

  • Blessing Health Hannibal Doing business as

Electronic endpoints 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230531002462 MO Part A Provider - Rural Health Clinic 3072422534 Practice locations: Hannibal, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457062101. Details of each certification follow.

Rural health clinic certification: CCN 268800

Legal name
BLESSING HOSPITAL
Doing business as
BLESSING HEALTH HANNIBAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 24, 2023
Last certification
Dec 7, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 29, 1973 in IL
Enrollment address
100 Medical Dr
Ste a, 1G, 1H
Hannibal, MO 63401-6877
Related CCNs
140015

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0441456Blessing Health Hannibal Main Laboratory100 Medical Drive, Hannibal, MO 63401AccreditationDec 22, 2027
26D2006949Blessing Health Hannibal100 Medical Drive, Hannibal, MO 63401Certificate of waiverMay 4, 2028
26D2314806Blessing Health Hannibal Radiology100 Medical Drive Suite B, Hannibal, MO 63401Certificate of waiverNov 26, 2026

National Provider Directory

National Provider Directory
Tax ID family
Blessing Hospital-Emerg35 organizations share this tax ID, including this one
Part of
Blessing Hospital-Emerg

Other organizations with this tax ID 34

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

View all 34

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

100 Medical Dr
Ste A1G1H
Hannibal, MO 63401
Phone (573) 231-3900

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mohamed Ali Individual Corporate DirectorBoard Member Oct 16, 2017
Amy Ruebush Individual Corporate DirectorBoard Member Mar 27, 2025
Joseph V Meyer Individual Corporate DirectorBoard Member Feb 1, 2026
Patrick Gerveler Individual Corporate OfficerCfo Apr 1, 2001
Corporate DirectorBoard Member Apr 1, 2001
Abby Reich Individual Corporate DirectorBoard Member Jan 1, 2013
Prashanth Podaralla Individual Corporate DirectorBoard Member Feb 1, 2026
Blessing Corporate Services, Inc. Organization, Quincy, IL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 24, 2023 100%
Mark Baumann Individual Corporate DirectorBoard Member Jan 25, 2024
Timothy Koontz Individual Corporate DirectorBoard Member May 8, 2006
Timothy Tranor Individual Corporate OfficerCoo / Cno / Interim Ceo Apr 16, 2025
Corporate DirectorBoard Member / Interim Ceo Apr 16, 2025
Operational/Managerial ControlCoo / Cno / Interim Ceo Apr 16, 2025
William H Dixon Individual Corporate DirectorBoard Member Feb 1, 2025
James Rinella Individual Corporate DirectorBoard Member Jan 25, 2024
Julie Brink Individual Corporate DirectorBoard Member Oct 16, 2017
Julie Duke Individual Corporate OfficerChief Revenue Cycle Officer Dec 1, 2022

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 20

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 20

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1457062101",
    "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": "100 MEDICAL DR STE A1G1H",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016877",
            "telephone_number": "573-231-3900",
            "fax_number": "573-231-3827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLESSING HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLESSING HOSPITAL",
        "enumeration_date": "2022-12-13",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "CANFIELD",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "217-223-8400"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "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": [
        {
            "organization_name": "Blessing Health Hannibal",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.