NPIMap

Organization Active NPI

Skaggs Community Hospital Association

Doing business as CoxHealth Family Medicine & Obstetrics

  • Rural Health Clinic/Center
  • Branson, MO
National Provider Identifier
1114005451
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SKAGGS COMMUNITY HOSPITAL ASSOCIATION
Doing business as
CoxHealth Family Medicine & Obstetrics
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
Last updated
Dec 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Authorized official

Name
William Mahoney
Title
President
Phone
(417) 335-7270

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

525 Branson Landing Blvd Ste 508
Branson, MO 65616-2131

Mailing address

PO Box 7411626
Chicago, IL 60674-5626

Other names 1

  • CoxHealth Family Medicine & Obstetrics Doing business as

Electronic endpoints 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114005451. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
525 Branson Landing Blvd Ste 508
Branson, MO 65616-2052
Related CCNs
260094

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

Other NPIs with the same Medicare PAC ID 16

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

View all 16

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
26D0917477Coxhealth Family Medicine & Obstetrics525 Branson Landing Blvd, Ste 508, Branson, MO 65616Certificate of waiverApr 7, 2028

National Provider Directory

National Provider Directory
Tax ID family
Skaggs Community Health29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Locations

1601 Branson Hills Pkwy
Ste 120
Branson, MO 65616
Phone (417) 335-7555

Ownership & related parties

All disclosed owners & managing parties 36

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

NameRoleSinceShare
Krystal Russell Individual Corporate DirectorBoard Member Feb 13, 2023
Jackson Gurley Individual W-2 Managing Employee Mar 15, 2026
Dennis J Heim Individual Corporate DirectorBoard Member Feb 13, 2023
James W Hutcheson Individual Corporate DirectorBoard Member Feb 13, 2023
Carol a Taylor Individual Corporate DirectorBoard Member Feb 13, 2023
Thomas Douglas Individual Corporate Director Nov 3, 2023
Logan Aguirre Individual Corporate Director Oct 1, 2025
Michelle Johnson Individual W-2 Managing Employee Mar 15, 2026
Stuart Lipscomb Individual Corporate Director Nov 3, 2023
Joseph W Turner Individual Corporate DirectorBoard Member Feb 13, 2023
Daniel Roth Individual Corporate DirectorVP of Operations May 22, 2024
Max Buetow Individual Corporate DirectorPresident/Ceo Feb 13, 2023
Charles T Chalender Individual Corporate DirectorBoard Member Feb 13, 2023
Nana a Gaisie Individual Corporate DirectorBoard Member Feb 13, 2023
Robert C Fulp Individual Corporate DirectorBoard Member Feb 13, 2023
Sara L. Hargis Individual Corporate DirectorBoard Member Feb 13, 2023
Larry W Lipscomb Individual Corporate DirectorBoard Member Feb 13, 2023
Brad E Erwin Individual Corporate DirectorBoard Member Feb 13, 2023
Pamela Yancey Individual Corporate Director Nov 3, 2023
Susan Graves Individual Corporate DirectorBoard Member Feb 13, 2023
Ibrahim I Abdalla Individual Corporate DirectorBoard Member Feb 13, 2023
Vickie Nelson Individual Corporate DirectorBoard Member Feb 13, 2023
Joselyn Baldner Individual Corporate Director Oct 1, 2025
Daphne R Lemon Individual Corporate DirectorBoard Member Feb 13, 2023
Julia L Flax Individual Corporate DirectorBoard Member Feb 13, 2023
Jefferson M Tynes Individual Corporate DirectorBoard Member Feb 13, 2023
Brian R. Jared Individual Corporate DirectorBoard Member Feb 13, 2023
William K Mahoney Individual Corporate DirectorPresident Cox Branson May 22, 2024
W-2 Managing EmployeePresident Cox Branson May 22, 2024
Jan M. Baumgartner Individual Corporate DirectorBoard Member Feb 13, 2023
Jacob M McWay Individual Corporate DirectorBoard Member Jan 1, 2015
Howard E Jarvis Individual Corporate DirectorBoard Member Feb 13, 2023
Hal Lynn Higdon Individual Corporate DirectorBoard Member Feb 13, 2023
The Bank of New York Mellon Trust Company Organization, New York, NY For-profit 5% Or Greater Mortgage Interest Nov 3, 2023 41%
Kurt D Hellweg Individual Corporate DirectorBoard Member Feb 13, 2023
Coxhealth Organization, Springfield, MO Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 1966 100%
Robert T Cox Individual Corporate DirectorBoard Member Jan 1, 2015

Owners & managing parties with NPI records 6

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

Facilities with the same owner 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766102400000",
    "number": "1114005451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7411626",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606745626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 BRANSON LANDING BLVD STE 508",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656162131",
            "telephone_number": "417-335-7540",
            "fax_number": "417-335-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKAGGS COMMUNITY HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-335-7270"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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 Healthcare 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": "CoxHealth Family Medicine & Obstetrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Branson, MO

Sources for this page

Verify at the official NPI Registry.