NPIMap

Organization Active NPI

Blessing Hospital

  • Rural Health Clinic/Center
  • Quincy, IL
National Provider Identifier
1700478203
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BLESSING HOSPITAL
Practice address
927 Broadway St
Quincy, IL 62301-2719
Phone
(217) 223-8400
NPI assigned
Feb 5, 2021
Last updated
Jul 11, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
BLESSING HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Authorized official

Name
Timothy A Moore
Title
VP Finance, Cao
Phone
(217) 223-8400

Specialties & licenses 1

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

Addresses

Primary practice location

927 Broadway St
Quincy, IL 62301-2719

Mailing address

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

Other names 1

  • Blessing Health - Main Other name

Electronic endpoints 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210518001811 IL Part A Provider - Rural Health Clinic 3072422534 Practice locations: Quincy, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700478203. Details of each certification follow.

Rural health clinic certification: CCN 148631

Legal name
BLESSING HOSPITAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 23, 2021
Last certification
Dec 23, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Oct 29, 1973 in IL
Enrollment address
927 Broadway St, Ste 120, 205, 220, 331
Quincy, IL 62301-2719
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
14D2218945Blessing Health Main927 Broadway, Quincy, IL 62301Certificate of waiverMar 30, 2027

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

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 Director Oct 16, 2017
Amy Ruebush Individual Corporate DirectorBoard Member Apr 16, 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 Director Jan 1, 2013
Prashanth Podaralla Individual Corporate DirectorBoard Member Feb 1, 2026
Blessing Corporate Services, Inc. Organization, Quincy, IL Corporation, Non-profit Operational/Managerial Control Jun 1, 2006
Mark Baumann Individual Corporate DirectorBoard Member Jan 25, 2024
Timothy Koontz Individual Corporate Director 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 Apr 16, 2025
James Rinella Individual Corporate DirectorBoard Member Jan 25, 2024
Julie Brink Individual Corporate Director 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

NPI Registry JSON

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1700478203",
    "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": "927 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012719",
            "telephone_number": "217-223-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLESSING HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLESSING HOSPITAL",
        "enumeration_date": "2021-02-05",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP FINANCE, CAO",
        "authorized_official_telephone_number": "217-223-8400"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "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 Health Care 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 - Main",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.