Rebekah Marie Blank, PA-C
Individual provider Active NPI Physician Assistant · Hannibal, MO
NPI 1689130775 · NPPES record last updated Jul 8, 2025
Key facts
- NPI
- 1689130775
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2025008099 (MO)
- Practice address
- 6500 Hospital Dr
Hannibal, MO 63401-6890 - Phone
- (573) 629-3500
- Fax
- (573) 629-3515
- NPI assigned
- Feb 14, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 20
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2019
- 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
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200416001308 | IL | Practitioner - Physician Assistant | 8527498419 | Reassigns benefits to 1 organization |
| I20250721001705 | MO | Practitioner - Physician Assistant | 8527498419 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85007552 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairfield Memorial Hospital Association | Current | Accepting new patients | |
| Hannibal Regional Healthcare System Inc | Current |
Accepting new patients | |
| Hannibal Regional Healthcare System, Inc | Current |
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
303 NW 11th St
Fairfield, IL 62837
Phone (618) 842-2611
213 NW 10th St
Ste A
Fairfield, IL 62837
Phone (618) 842-4617
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
- https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
- rtallcott@oci2123.srs-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 85007552 | IL | |
| Physician Assistant | 363A00000X | 2025008099 | MO | Yes |
Addresses
Primary practice location
6500 Hospital Dr
Hannibal, MO 63401-6890
Mailing address
PO Box 1239
Hannibal, MO 63401-1239
Phone (573) 629-3500
Other providers in Hannibal, MO
- Beth Haven Group Homes Inc
- Beth Haven Group Homes Inc
- Christopher Michael Bieniek
- Taylor Renee Bieniek
- Kory Dane Blank
- Kelley Blasa
- Kae Lynn Blecha
- Blessing Hospital
- Blessing Hospital
- Blessing Hospital
All providers in Hannibal, MO · Physician Assistant 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.