Kory Dane Blank, M.D
Individual provider Active NPI Orthopaedic Surgery Physician · Hannibal, MO
NPI 1508214669 · NPPES record last updated Jul 8, 2025
Key facts
- NPI
- 1508214669
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- 2025020901 (MO)
- Practice address
- 6500 Hospital Dr
Hannibal, MO 63401-6890 - Phone
- (573) 629-3500
- Fax
- (573) 629-3370
- NPI assigned
- May 31, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Orthopedic Surgery
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hannibal Regional Healthcare System Inc
Practice addresses (Care Compare)
6500 Hospital Dr
Hannibal, MO 63401-6890
Phone (573) 248-1300
Hospital & facility affiliations
- Hannibal Regional Hospital Home Health Agency
- Hannibal Regional Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 1-10 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Removal of nail tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210826002227 | IL | Practitioner - Orthopedic Surgery | 1759673478 | |
| I20250626002935 | MO | Practitioner - Orthopedic Surgery | 1759673478 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hannibal Regional Healthcare System, Inc | Current |
Accepting new patients | |
| Hannibal Regional Healthcare System Inc | Current |
Accepting new patients | |
| Hannibal Regional Healthcare System, Inc | Past | Accepting new patients |
Locations
8 Town Center Dr
Bowling Green, MO 63334
Phone (573) 324-2241
6000 Hospital Dr
Hannibal, MO 63401
Phone (573) 248-5460
6500 Hospital Dr
Hannibal, MO 63401
Phone (573) 629-3400
Interoperability endpoints
- https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
- kblank@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 125.068544 | IL | |
| Orthopaedic Surgery Physician | 207X00000X | 2025020901 | MO | Yes |
Addresses
Primary practice location
6500 Hospital Dr
Hannibal, MO 63401-6890
Mailing address
PO Box 1259
Hannibal, MO 63401-1259
Phone (573) 629-3500
Other practice location 1
303 NW 11th St
Fairfield, IL 62837-1203
Phone (618) 847-4282
Other practice location 2
701 N 1st St
Springfield, IL 62702-3757
Phone (217) 545-8000
Other providers in Hannibal, MO
- Beth Haven Group Homes Inc
- Beth Haven Group Homes Inc
- Beth Haven Group Homes Inc
- Christopher Michael Bieniek
- Taylor Renee Bieniek
- Rebekah Marie Blank
- Kelley Blasa
- Kae Lynn Blecha
- Blessing Hospital
- Blessing Hospital
All providers in Hannibal, MO · Orthopaedic Surgery Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2025. 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.
- Order and Referring (CMS).
- 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.