NPIMap

Organization Active NPI

Skaggs Community Hospital Association

Doing business as CoxHealth Branson Hills Clinic

  • Rural Health Clinic/Center
  • Branson, MO
National Provider Identifier
1629156971
Registry record updated Jun 18, 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 Branson Hills Clinic
Practice address
1601 Branson Hills Pkwy Ste 100
Branson, MO 65616-9908
Phone
(417) 348-8964
Fax
(417) 336-0275
NPI assigned
Nov 2, 2006
Last updated
Jun 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Authorized official

Name
Mr. William K Mahoney
Title
Chief Execxutive Officer
Phone
(417) 335-7270

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

1601 Branson Hills Pkwy Ste 100
Branson, MO 65616-9908

Mailing address

PO Box 7411626
Chicago, IL 60674-5626

Other names 1

  • CoxHealth Branson Hills 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 MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080229000186 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 1629156971. Details of each certification follow.

Rural health clinic certification: CCN 268595

Legal name
SKAGGS COMMUNITY HOSPITAL ASSOCIATION
Doing business as
COXHEALTH BRANSON HILLS CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 30, 2005
Last certification
Sep 26, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
1601 Branson Hills Pkwy
Ste 100
Branson, MO 65616-9908
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

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
26D2300856Coxhealth Branson Hills Clinic1601 Branson Hills Pkwy Ste 100, Branson, MO 65616Certificate of waiverMar 17, 2028

National Provider Directory

National Provider Directory
Tax ID family
Branson Family Medicine28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Locations

1601 Branson Hills Pkwy
Ste 100
Branson, MO 65616
Phone (417) 348-8964

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 Director Nov 17, 2021
Jackson Gurley Individual W-2 Managing Employee Mar 15, 2026
Dennis J Heim Individual Corporate Director Nov 17, 2021
James W Hutcheson Individual Corporate Director Nov 17, 2021
Carol a Taylor Individual Corporate Director Nov 17, 2021
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 Director Nov 17, 2021
Daniel Roth Individual Operational/Managerial ControlVP of Operations Apr 1, 2024
Max Buetow Individual Corporate OfficerPresident/Ceo Jun 1, 2022
Charles T Chalender Individual Corporate Director Nov 17, 2021
Nana a Gaisie Individual Corporate Director Nov 17, 2021
Robert C Fulp Individual Corporate Director Nov 17, 2021
Sara L. Hargis Individual Corporate Director Nov 17, 2021
Larry W Lipscomb Individual Corporate Director Nov 17, 2021
Brad E Erwin Individual Corporate Director Nov 17, 2021
Pamela Yancey Individual Corporate Director Nov 3, 2023
Susan Graves Individual Corporate Director Nov 17, 2021
Ibrahim I Abdalla Individual Corporate Director Nov 17, 2021
Vickie Nelson Individual Corporate Officer Nov 17, 2021
Joselyn Baldner Individual Corporate Director Oct 1, 2025
Daphne R Lemon Individual Corporate Director Nov 17, 2021
Julia L Flax Individual Corporate Director Nov 17, 2021
Jefferson M Tynes Individual Corporate Director Nov 17, 2021
Brian R. Jared Individual Corporate Director Nov 17, 2021
William K Mahoney Individual Operational/Managerial ControlPresident/Ceo Jan 1, 2015
Jan M. Baumgartner Individual Corporate Director Nov 17, 2021
Jacob M McWay Individual Corporate OfficerVice President/Cfo Jan 1, 2025
Howard E Jarvis Individual Corporate Director Nov 17, 2021
Hal Lynn Higdon Individual Corporate Director Nov 17, 2021
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 Director Nov 17, 2021
Coxhealth Organization, Springfield, MO Holding company 5% Or Greater Direct Ownership Interest Dec 30, 2013 100%
Operational/Managerial Control Dec 30, 2013
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 4

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": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1629156971",
    "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": "1601 BRANSON HILLS PKWY STE 100",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656169908",
            "telephone_number": "417-348-8964",
            "fax_number": "417-336-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKAGGS COMMUNITY HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF EXECXUTIVE OFFICER",
        "authorized_official_telephone_number": "417-335-7270",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Branson Hills Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CoxHealth Branson Hills Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Branson, MO

Sources for this page

Verify at the official NPI Registry.