Individual provider Active NPI

Rebekah Marie Blank, PA-C

  • Physician Assistant
  • Hannibal, MO
National Provider Identifier
1689130775
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2025008099 Issued in MO
Practice address
6500 Hospital Dr
Hannibal, MO 63401-6890
Phone
(573) 629-3500
Fax
(573) 629-3515
NPI assigned
Feb 14, 2019
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 85007552 IL
Physician Assistant 363A00000X 2025008099 MO Primary

Addresses

Primary practice location

6500 Hospital Dr
Hannibal, MO 63401-6890

Mailing address

PO Box 1239
Hannibal, MO 63401-1239
Phone (573) 629-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200416001308 IL Practitioner - Physician Assistant 8527498419 Reassigns benefits to 1 organization
I20250721001705 MO Practitioner - Physician Assistant 8527498419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6500 Hospital Dr
Hannibal, MO 63401-6890
Phone (573) 248-1300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
85007552ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hannibal Regional Healthcare System Inc CurrentSince Jul 15, 2025 Accepting new patients
Hannibal Regional Healthcare System, Inc CurrentSince Jul 15, 2025 Accepting new patients
Fairfield Memorial Hospital Association CurrentSince Jul 1, 2021 Accepting new patients
Fairfield Memorial Hospital Association Current Accepting new patients
Orthopaedic Center of Illinois Past Accepting new patients
Hannibal Regional Healthcare System, Inc Past Accepting new patients

Locations

213 NW 10th St
Ste A
Fairfield, IL 62837
Phone (618) 842-4617

303 NW 11th St
Fairfield, IL 62837
Phone (618) 842-2611

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

1600 N Morley St
Moberly, MO 65270
Phone (660) 263-1225

1811 S Main St
Palmyra, MO 63461
Phone (573) 769-2231

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
  • Direct secure messaging: rtallcott@oci2123.srs-direct.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1689130775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634011239",
            "telephone_number": "573-629-3500",
            "fax_number": "573-629-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016890",
            "telephone_number": "573-629-3500",
            "fax_number": "573-629-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANK",
        "first_name": "REBEKAH",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-14",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "85007552",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2025008099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.