NPIMap

Organization Active NPI

Hannibal Regional Healthcare System, Inc

Doing business as Hannibal Regional Hospital Home Health Agency

  • Home Health Agency
  • Hannibal, MO
National Provider Identifier
1992726731
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC
Doing business as
Hannibal Regional Hospital Home Health Agency
Practice address
4601 Highway MM
Hannibal, MO 63401-6918
Phone
(573) 221-6515
NPI assigned
Jul 21, 2006
Last updated
Aug 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Authorized official

Name
Robert N Gasaway
Title
Cfo
Phone
(573) 406-1609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

4601 Highway MM
Hannibal, MO 63401-6918

Mailing address

PO Box 1239
Hannibal, MO 63401-1239
Phone (573) 406-1609

Other identifiers 1

IdentifierTypeStateIssuer
580416006MedicaidMO

Other names 1

  • Hannibal Regional Hospital Home Health Agency Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080118000525 MO Part A Provider - Home Health Agency 1254236300 Practice locations: Hannibal, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992726731. Details of each certification follow.

Home health agency certification: CCN 267282

Legal name
HANNIBAL REGIONAL HEALTHCARE SYSTEM INC
Doing business as
HANNIBAL REGIONAL HOSPITAL HOME HEALTH AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 19, 1990
Last certification
Oct 3, 2018
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Aug 6, 1965 in MO
Enrollment address
4601 Highway MM
Hannibal, MO 63401-6918
HHA Branch

Other NPIs with the same Medicare PAC ID 15

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

View all 15

Care Compare: Home health agency

Medicare Care Compare
Listed as
Hannibal Regional Hospital Home Health AgencyCCN 267282 · All quality measures
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Feb 19, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Hannibal Regional Healt33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

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

View all 32

Locations

4601 Highway MM
Hannibal, MO 63401
Phone (573) 221-6515

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Hannibal Regional Healthcare System Inc Organization, Hannibal, MO Created for acquisition 5% Or Greater Direct Ownership Interest Feb 22, 2012 100%
Operational/Managerial Control Feb 6, 2017 100%
Robert N Gasaway Individual Corporate Officer Feb 6, 2017 100%
Operational/Managerial ControlVP of Finance Feb 6, 2017 100%
Christopher T Ahrens Individual Corporate Officer Jan 1, 2013
Operational/Managerial ControlCeo Jan 1, 2013 100%

Owners & managing parties with NPI records 15

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

View all 15

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hannibal Regional HospitalHannibal, MO, CCN 260025 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 20, 2014
Apr 1, 2014
Hannibal Regional Inpatient RehabilitationHannibal, MO, CCN 26T025 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 20, 2014
Apr 1, 2014
Monroe City Family PracticeMonroe City, MO, CCN 268513 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2014
Apr 1, 2014
Shelbina Family PracticeShelbina, MO, CCN 268512 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2014
Apr 1, 2014
Canton-Lagrange Family PracticeCanton, MO, CCN 263984 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 3, 1992
Apr 30, 1992
Pike Medical ClinicLouisiana, MO, CCN 268723 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2014
Apr 1, 2014
Hannibal Regional Medical Group-Bowling GreenBowling Green, MO, CCN 268724 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2014
Apr 1, 2014
Hannibal Regional Medical GroupHannibal, MO, CCN 268754 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2016
Express Care at WalmartHannibal, MO, CCN 268759 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Nov 1, 2016
Oct 1, 2012
Complete Family Medicine Lancaster RHCLancaster, MO, CCN 268757 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 3, 2017
Jul 3, 2017
Complete Family Medicine la Plata RHCLa Plata, MO, CCN 268756 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 3, 2017
Jul 3, 2017
Complete Family Medicine Kirksville RHCKirksville, MO, CCN 268758 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 3, 2017
Jul 3, 2017

Owned or controlled facilities with NPI records 12

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

Affiliated clinicians 20

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565827200000",
    "number": "1992726731",
    "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": "573-406-1609",
            "fax_number": "573-406-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 HIGHWAY MM",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016918",
            "telephone_number": "573-221-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2019-08-15",
        "status": "A",
        "authorized_official_last_name": "GASAWAY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-406-1609"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "580416006",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hannibal Regional Hospital Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hannibal Regional Hospital Home Health Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.