NPIMap

Organization Active NPI

Sgoh Acquisition, Inc.

  • Rural Health Clinic/Center
  • Anderson, MO
National Provider Identifier
1063969665
Registry record updated Nov 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SGOH ACQUISITION, INC.
Practice address
104 E Main St
Anderson, MO 64831-4103
Phone
(417) 845-6984
NPI assigned
Sep 1, 2016
Last updated
Nov 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2017

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

Authorized official

Name
Paul Taylor, JD
Title
Ceo
Phone
(417) 837-4090

Specialties & licenses 1

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

Addresses

Primary practice location

104 E Main St
Anderson, MO 64831-4103

Mailing address

104 E Main St
Anderson, MO 64831-4103
Phone (417) 845-6984

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170207000588 AR Part A Provider - Rural Health Clinic 5092616276 Practice locations: Anderson, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063969665. Details of each certification follow.

Rural health clinic certification: CCN 268747

Legal name
SGOH ACQUISITION INC
Doing business as
OCH ANDERSON RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 28, 1994
Last certification
May 14, 2026
Ownership / control type
2B
Most recent change of ownership
Jan 1, 2017 (1 total)
Organization structure
CorporationProprietary
Incorporated
Aug 21, 1991 in MO
Enrollment address
104 E Main St
Anderson, MO 64831-4103
Related CCNs
041331

Facilities connected through Provider of Services related, parent or unit certification numbers.

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

National Provider Directory

National Provider Directory
Tax ID family
Doctors Hospital Spring8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Paul G Taylor Individual Corporate DirectorCeo Jan 1, 2017 100%
W-2 Managing EmployeeCeo Jan 1, 2017 100%
Sgoh Acquisition Inc Organization, Gravette, AR Corporation 5% Or Greater Direct Ownership Interest Jan 1, 2017 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 14

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

FacilityTypeRoleSince
Ozarks Community Hospital of GravetteGravette, AR, CCN 041331 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 May 16, 2008
Dec 31, 2021
Ozarks Community Hospital of GravetteGravette, AR, CCN 04Z331 Hospital Operational/Managerial Control (100%) Dec 31, 2021
Och McDonald County ClinicNoel, MO, CCN 268695 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 19, 2013
Och Sparta ClinicSparta, MO, CCN 268726 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2014
Och Lawrence County ClinicMt. Vernon, MO, CCN 268597 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015
Och Wellpointe Family Medical ClinicMarshfield, MO, CCN 268672 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015
Och Jasper County Clinic Carthage CampusCarthage, MO, CCN 268728 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 1, 2015
Och Pineville Medical ClinicPineville, MO, CCN 268748 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2017
Och Southwest City Community ClinicSouth West City, MO, CCN 268746 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2017
Och Goodman Family ClinicGoodman, MO, CCN 268745 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2017
Och Newton County ClinicNeosho, MO, CCN 268778 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2020
Jan 1, 2020
Sgoh Acquisition IncRogers, AR, CCN 048529 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control (100%)		 Aug 1, 2020
Aug 1, 2020
Och Webster County ClinicRogerville, MO, CCN 268609 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015
Sgoh Acquisition IncDecatur, AR, CCN 048548 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 5, 2024
Aug 5, 2024

Owned or controlled facilities with NPI records 14

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

View all 14

Facilities with the same owner 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510876800000",
    "number": "1063969665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E MAIN ST",
            "city": "ANDERSON",
            "state": "MO",
            "postal_code": "648314103",
            "telephone_number": "417-845-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E MAIN ST",
            "city": "ANDERSON",
            "state": "MO",
            "postal_code": "648314103",
            "telephone_number": "417-845-6984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SGOH ACQUISITION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2017-11-17",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-837-4090",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, MO

Sources for this page

Verify at the official NPI Registry.