Skaggs Community Hospital Association
Organization Active NPI Rural Health Clinic/Center · Branson, MO
NPI 1114005451 · NPPES record last updated Dec 19, 2025
Key facts
- NPI
- 1114005451
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- SKAGGS COMMUNITY HOSPITAL ASSOCIATION
- Practice address
- 525 Branson Landing Blvd Ste 508
Branson, MO 65616-2131 - Phone
- (417) 335-7540
- Fax
- (417) 335-7544
- NPI assigned
- Nov 2, 2006
- Organization subpart
- No
Authorized official
- Name
- William Mahoney
- Title
- President
- Phone
- (417) 335-7270
Owners & managing parties with NPI records 6
-
Ibrahim Abdalla, M.D.
-
Julia L. Flax, M.D.
-
Susan E. Graves, M.D.
-
Howard Jarvis III, M.D.
-
Daphne R Lemon, MD
Other NPIs on the same Medicare enrollment 6
Other NPIs with the same Medicare PAC ID 16
Corporate family (same tax ID) 27
Member of 1
Related certifications (CCN) 1
Facilities with the same owner 24
Practitioners 228
-
Ronda D. Azelton, DO
-
Catherine Edele Benbow, D.O.
-
Angela Conklin, DO
-
Megan Fox, FNP-C
-
Dayna Jett, MD
-
Amanda Phelps, MA, LPC
-
Betty Abban, M.D.
-
Sheny Alex, MD
-
Mark Jeffrey Allen, FNP-BC
-
Nicholas Robert Anderson, M.D.
-
Narin Arunakul, M.D.
-
Sarah Jeanne Austin, PA-C
-
Jacob Lee Baalman, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D0917477 | Coxhealth Family Medicine & Obstetrics | Certificate of waiver | Apr 7, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO
Rural health clinic certification: CCN 263496
- Legal name
- SKAGGS COMMUNITY HOSPITAL ASSOCIATION
- Doing business as
- COXHEALTH FAMILY MEDICINE & OBSTETRICS
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Aug 21, 1996
- Last certification
- Apr 29, 2019
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 525 Branson Landing Blvd Ste 508
Branson, MO 65616-2052 - Related CCNs
- 260094
All disclosed owners & managing parties 36
| Name | Role | Since | Share |
|---|---|---|---|
| Krystal Russell |
Corporate Director |
Feb 13, 2023 | |
| Jackson Gurley |
W-2 Managing Employee | Mar 15, 2026 | |
| Dennis J Heim |
Corporate Director |
Feb 13, 2023 | |
| James W Hutcheson |
Corporate Director |
Feb 13, 2023 | |
| Carol a Taylor |
Corporate Director |
Feb 13, 2023 | |
| Thomas Douglas |
Corporate Director | Nov 3, 2023 | |
| Logan Aguirre |
Corporate Director | Oct 1, 2025 | |
| Michelle Johnson |
W-2 Managing Employee | Mar 15, 2026 | |
| Stuart Lipscomb |
Corporate Director | Nov 3, 2023 | |
| Joseph W Turner |
Corporate Director |
Feb 13, 2023 | |
| Daniel Roth |
Corporate Director |
May 22, 2024 | |
| Max Buetow |
Corporate Director |
Feb 13, 2023 | |
| Charles T Chalender |
Corporate Director |
Feb 13, 2023 | |
| Nana a Gaisie |
Corporate Director |
Feb 13, 2023 | |
| Robert C Fulp |
Corporate Director |
Feb 13, 2023 | |
| Sara L. Hargis |
Corporate Director |
Feb 13, 2023 | |
| Larry W Lipscomb |
Corporate Director |
Feb 13, 2023 | |
| Brad E Erwin |
Corporate Director |
Feb 13, 2023 | |
| Pamela Yancey |
Corporate Director | Nov 3, 2023 | |
| Susan Graves |
Corporate Director |
Feb 13, 2023 | |
| Ibrahim I Abdalla |
Corporate Director |
Feb 13, 2023 | |
| Vickie Nelson |
Corporate Director |
Feb 13, 2023 | |
| Joselyn Baldner |
Corporate Director | Oct 1, 2025 | |
| Daphne R Lemon |
Corporate Director |
Feb 13, 2023 | |
| Julia L Flax |
Corporate Director |
Feb 13, 2023 | |
| Jefferson M Tynes |
Corporate Director |
Feb 13, 2023 | |
| Brian R. Jared |
Corporate Director |
Feb 13, 2023 | |
| William K Mahoney |
Corporate Director |
May 22, 2024 | |
| W-2 Managing Employee |
May 22, 2024 | ||
| Jan M. Baumgartner |
Corporate Director |
Feb 13, 2023 | |
| Jacob M McWay |
Corporate Director |
Jan 1, 2015 | |
| Howard E Jarvis |
Corporate Director |
Feb 13, 2023 | |
| Hal Lynn Higdon |
Corporate Director |
Feb 13, 2023 | |
| The Bank of New York Mellon Trust Company |
5% Or Greater Mortgage Interest | Nov 3, 2023 | 41% |
| Kurt D Hellweg |
Corporate Director |
Feb 13, 2023 | |
| Coxhealth |
5% Or Greater Indirect Ownership Interest | Jan 1, 1966 | 100% |
| Robert T Cox |
Corporate Director |
Jan 1, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040129000626 | MO | Part B Supplier - Clinic/Group Practice | 5092624320 |
Receives reassigned benefits from 71 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Branson, MO; Joplin, MO |
| O20080228000268 | MO | Part a Provider - Rural Health Clinic | 5092624320 | Practice locations: Branson, MO |
National Provider Directory
- Tax ID family
- Skaggs Specialty Clinic
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
525 Branson Landing Blvd Ste 508
Branson, MO 65616-2131
Mailing address
PO Box 7411626
Chicago, IL 60674-5626
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 598594901 | Medicaid | MO | |
| 507954006 | Medicaid | MO |
Other names
- CoxHealth Family Medicine & Obstetrics
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Cobius Healthcare Solutions |
Other providers in Branson, MO
- Skaggs Community Hospital Association
- Skaggs Community Hospital Association
- Skaggs Community Hospital Association
- Skaggs Community Hospital Association
- Skaggs Community Hospital Association
- Skaggs Community Hospital Association
- Skaggs Community Hospital Association
- Skaggs Community Hospital Association
- Skaggs Community Hospital Association
- Skaggs Community Hospital Association
All providers in Branson, 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 Dec 19, 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.