NPIMap

Organization Active NPI

Sgoh Acquisition Inc

Doing business as Och Benton County Clinic

  • Rural Health Clinic/Center
  • Rogers, AR
National Provider Identifier
1154945483
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SGOH ACQUISITION INC
Doing business as
Och Benton County Clinic
Practice address
102 Russell Road
Rogers, AR 72756
Phone
(479) 278-7189
Fax
(479) 278-2199
NPI assigned
Jun 2, 2020
Last updated
Jun 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Authorized official

Name
Paul G Taylor
Title
Ceo
Phone
(417) 837-4004

Specialties & licenses 1

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

Addresses

Primary practice location

102 Russell Road
Rogers, AR 72756

Mailing address

102 Russell Road
Rogers, AR 72756

Other names 1

  • OCH BENTON COUNTY CLINIC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200617003148 AR Part A Provider - Rural Health Clinic 5092616276 Practice locations: Rogers, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154945483. Details of each certification follow.

Rural health clinic certification: CCN 048529

Legal name
SGOH ACQUISITION INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 5, 2021
Last certification
Apr 11, 2024
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Aug 21, 1991 in MO
Enrollment address
102 Russell Rd
Rogers, AR 72756-9319
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

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
04D2186272Och Benton County Clinic102 Russell Rd, Rogers, AR 72756Certificate of waiverJun 15, 2028

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 W-2 Managing EmployeeCeo Aug 1, 2020 100%
Sgoh Acquisition Inc Organization, Gravette, AR Corporation, For-profit 5% Or Greater Direct Ownership Interest Aug 1, 2020
Operational/Managerial Control Aug 1, 2020 100%

Owners & managing parties with NPI records 15

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

  • Sgoh Acquisition Inc

    dba Ozarks Community Hospital of Gravette

    • Critical Access Hospital
    • Gravette, AR
    • NPI 1568643005

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Sgoh Acquisition Inc

    dba Och Decatur Clinic

    • Rural Health Clinic/Center
    • Decatur, AR
    • NPI 1699513507

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Sgoh Acquisition Inc

    dba Ozarks Community Hospital of Gravette

    • Medicare Defined Swing Bed Hospital Unit
    • Gravette, AR
    • NPI 1780943357

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Sgoh Acquisition Inc
    • Clinic/Center
    • Springfield, MO
    • NPI 1114924768

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Sgoh Acquisition Inc

    dba Och Lawrence County Clinic

    • Rural Health Clinic/Center
    • Mount Vernon, MO
    • NPI 1568502631

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Sgoh Acquisition Inc

    dba Och Webster County Clinic

    • Rural Health Clinic/Center
    • Rogersville, MO
    • NPI 1942335203

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Sgoh Acquisition, Inc.
    • Rural Health Clinic/Center
    • Anderson, MO
    • NPI 1063969665

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Sgoh Acquisition, Inc.

    dba Och Jasper County Clinic Carthage Campus

    • Rural Health Clinic/Center
    • Carthage, MO
    • NPI 1104229186

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Sgoh Acquisition, Inc.

    dba Och Wellpointe Family Medical Clinic

    • Rural Health Clinic/Center
    • Marshfield, MO
    • NPI 1225338155

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Sgoh Acquisition, Inc.
    • Rural Health Clinic/Center
    • Pineville, MO
    • NPI 1386191989

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Sgoh Acquisition, Inc.

    dba Och McDonald County Clinic

    • Rural Health Clinic/Center
    • Noel, MO
    • NPI 1386985521

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Sgoh Acquisition, Inc.
    • Rural Health Clinic/Center
    • South West City, MO
    • NPI 1801343405

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
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 Anderson Rural Health ClinicAnderson, MO, CCN 268747 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
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": "1591056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1154945483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 RUSSELL ROAD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 RUSSELL ROAD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72756",
            "telephone_number": "479-278-7189",
            "fax_number": "479-278-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SGOH ACQUISITION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-837-4004"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OCH BENTON COUNTY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OCH BENTON COUNTY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.