Sgoh Acquisition, Inc.
Organization Active NPI Rural Health Clinic/Center · Carthage, MO
NPI 1104229186 · NPPES record last updated Jun 3, 2025
Key facts
- NPI
- 1104229186
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- SGOH ACQUISITION, INC.
- Practice address
- 215 E 3Rd St
Carthage, MO 64836-1661 - Phone
- (417) 237-0604
- Fax
- (417) 237-0613
- NPI assigned
- Oct 3, 2014
- Organization subpart
- No
Authorized official
- Name
- Paul G Taylor
- Title
- Ceo
- Phone
- (417) 837-4090
Owners & managing parties with NPI records 15
Owned or controlled facilities with NPI records 14
Other NPIs with the same Medicare PAC ID 15
Member of 1
Related certifications (CCN) 1
Facilities with the same owner 14
Practitioners 95
-
Shannon Alvarez, FNP
-
Steven R Barnes, FNP
-
Jackie Beene, MD
-
Angela R Bridges, NP-CO
-
Janiece Rachelle Bridges, M.D.
-
Sunshine Leeann Bunch, FNP-C
-
Linda C Burdett, FNP
-
Jessica Burks, FNP-C
-
John Stephen Carpenter, MSW, LCSW
-
Fernando Cavero, M.D.
-
Robin L Cavero, FNP
-
Amanda J Chapman, MSN-NP
-
Arthur Joe Cohn, DO
-
Latoya M. Compton, FNP
-
Justin Lee Cope, APRN
-
Coral L Couchenour, D.O.
-
Zachary Edward Dampier, MSN, APRN, PMHNP-BC
-
Bonnie Janeen Daniel, FNP-C
-
Lorri Jean Darrow, MD, PSYD
-
Frederick M. Faust, M.D.
-
Jerald Delbert Forsyth, PSY.D.
-
Tyler Gammon, DO
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D1088734 | Och Jasper County Clinic | Certificate of waiver | Sep 2, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Rural health clinic certification: CCN 268728
- Legal name
- SGOH ACQUISITION INC
- Doing business as
- OCH JASPER COUNTY CLINIC CARTHAGE CAMPUS
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- May 19, 2015
- Last certification
- Apr 27, 2023
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Aug 21, 1991 in MO
- Enrollment address
- 215 E 3Rd St
Carthage, MO 64836-1661 - Related CCNs
- 041331
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Paul G Taylor |
W-2 Managing Employee |
Jan 1, 2015 | 100% |
| Sgoh Acquisition Inc |
5% Or Greater Direct Ownership Interest | Jan 1, 2015 |
All facility ownership & control disclosures 14
| Facility | Type | Role | Since |
|---|---|---|---|
| Ozarks Community Hospital of Gravette |
Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
May 16, 2008 Dec 31, 2021 |
| Ozarks Community Hospital of Gravette |
Hospital | Operational/Managerial Control (100%) | Dec 31, 2021 |
| Och McDonald County Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Dec 19, 2013 |
| Och Sparta Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Nov 1, 2014 |
| Och Lawrence County Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2015 |
| Och Wellpointe Family Medical Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2015 |
| Och Pineville Medical Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2017 |
| Och Southwest City Community Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2017 |
| Och Goodman Family Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2017 |
| Och Anderson Rural Health Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2017 |
| Och Newton County Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 1, 2020 Jan 1, 2020 |
| Sgoh Acquisition Inc |
Rural health clinic | 5% Or Greater Direct Ownership Interest Operational/Managerial Control (100%) |
Aug 1, 2020 Aug 1, 2020 |
| Och Webster County Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2015 |
| Sgoh Acquisition Inc |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Aug 5, 2024 Aug 5, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150611002608 | MO | Part a Provider - Rural Health Clinic | 5092616276 | Practice locations: Carthage, MO |
National Provider Directory
Locations
215 E 3rd St
Carthage, MO 64836
Phone (417) 237-0604
1310 N Hovis St
Mountain Grove, MO 65711
Phone (417) 926-5128
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
215 E 3Rd St
Carthage, MO 64836-1661
Mailing address
215 E 3Rd St
Carthage, MO 64836-1661
Phone (417) 237-0604
Other practice location 1
327 E Airport Dr
Carthage, MO 64836-3402
Phone (417) 237-0604
Other names
- OCH JASPER COUNTY CLINIC CARTHAGE CAMPUS
Other providers in Carthage, MO
- Roger A. Sacry I
- Mark F Saladin
- Tyge L Sanborn
- Wesley Schemmer
- Seeds of Hope Non Medical in Home Health Care
- Harold A Smart
- Pamela D. Smith
- Tamra Leona Soriano
- Laura Jean South
- Southwest Missouri Bone & Joint, Inc.
All providers in Carthage, MO · Rural Health Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- 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.