NPIMap

Organization Active NPI

Cox Barton County Hospital

Doing business as Medical One Clinic

  • Rural Health Clinic/Center
  • Lamar, MO
National Provider Identifier
1255847745
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
COX BARTON COUNTY HOSPITAL
Doing business as
Medical One Clinic
Practice address
29 NW 1St LN
Lamar, MO 64759-8105
Phone
(417) 681-5284
Fax
(417) 681-5514
NPI assigned
Dec 19, 2017
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
Daniel Roth
Title
VP of Operations
Phone
(417) 269-3014

Specialties & licenses 2

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

Addresses

Primary practice location

29 NW 1St LN
Lamar, MO 64759-8105

Mailing address

PO Box 7411626
Chicago, IL 60674-5626

Other names 1

  • MEDICAL ONE CLINIC 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
O20200116001299 MO Part B Supplier - Clinic/Group Practice 8820329782 Receives reassigned benefits from 87 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Joplin, MO; Lamar, MO
O20200306000220 MO Part A Provider - Rural Health Clinic 8820329782 Practice locations: Lamar, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255847745. Details of each certification follow.

Rural health clinic certification: CCN 268648

Legal name
COX BARTON COUNTY HOSPITAL
Doing business as
MEDICAL ONE CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 12, 2010
Last certification
Oct 17, 2023
Ownership / control type
Non-profit – church related
Most recent change of ownership
Jan 1, 2018 (1 total)
Organization structure
CorporationNon-profit
Enrollment address
29 NW 1St LN
Lamar, MO 64759-8105
Related CCNs
261325

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 34

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 Director Nov 29, 2021
Jackson Gurley Individual W-2 Managing Employee Mar 15, 2026
Dennis J Heim Individual Corporate DirectorBoard Member Oct 1, 2019
James W Hutcheson Individual Corporate DirectorBoard Member Oct 1, 2019
Carol a Taylor Individual Corporate Director Nov 29, 2021
Thomas Douglas Individual Corporate Director Oct 1, 2023
Logan Aguirre Individual Corporate Officer Oct 1, 2025
Michelle Johnson Individual W-2 Managing Employee Mar 15, 2026
Stuart Lipscomb Individual Corporate Director Oct 1, 2023
Joseph W Turner Individual Corporate Director Nov 29, 2021
Daniel Roth Individual Corporate OfficerVP of Operations Oct 1, 2023
Corporate DirectorVP of Operations Oct 1, 2023
W-2 Managing EmployeeVP of Operations Oct 1, 2023
Max Buetow Individual Corporate OfficerPresident Oct 1, 2023
Corporate DirectorPresident Oct 1, 2023
Charles T Chalender Individual Corporate OfficerChairman of the Board Oct 1, 2019
Corporate Director Oct 1, 2019
Nana a Gaisie Individual Corporate Director Nov 29, 2021
Robert C Fulp Individual Corporate DirectorBoard Member Oct 1, 2019
Sara L. Hargis Individual Corporate DirectorBoard Member Oct 1, 2019
Larry W Lipscomb Individual Corporate Director Nov 29, 2021
Brad E Erwin Individual Corporate Director Nov 29, 2021
Pamela Yancey Individual Corporate Director Oct 1, 2023
Susan Graves Individual Corporate Director Nov 29, 2021
Ibrahim I Abdalla Individual Corporate DirectorBoard Member Oct 1, 2019
Vickie Nelson Individual Corporate OfficerSecretary Oct 1, 2019
Joselyn Baldner Individual Corporate Officer Oct 1, 2025
Daphne R Lemon Individual Corporate Director Nov 29, 2021
Julia L Flax Individual Corporate Director Nov 29, 2021
Jefferson M Tynes Individual Corporate Director Nov 29, 2021
Brian R. Jared Individual Corporate DirectorBoard Member Oct 1, 2019
Jan M. Baumgartner Individual Corporate DirectorBoard Member Oct 1, 2019
Jacob M McWay Individual Operational/Managerial Control Jan 1, 2018
Howard E Jarvis Individual Corporate Director Nov 29, 2021
Hal Lynn Higdon Individual Corporate DirectorBoard Member Oct 1, 2019
Kurt D Hellweg Individual Corporate DirectorBoard Member Oct 1, 2019
Coxhealth Organization, Springfield, MO Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2018 100%
Robert T Cox Individual Corporate Director Nov 29, 2021

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

Change-of-ownership history 1

DateEventCounterparty
Jan 1, 2018 Change of OwnershipThis provider was the buyer CBCH LLCCCN 268762, MO, NPI 1295241784

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766102400000",
    "number": "1255847745",
    "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": "29 NW 1ST LN",
            "city": "LAMAR",
            "state": "MO",
            "postal_code": "647598105",
            "telephone_number": "417-681-5284",
            "fax_number": "417-681-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COX BARTON COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "417-269-3014"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "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": "MEDICAL ONE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lamar, MO

Sources for this page

Verify at the official NPI Registry.