NPIMap

Organization Active NPI

Sgoh Acquisition, Inc.

  • Rural Health Clinic/Center
  • Goodman, MO
National Provider Identifier
1972050581
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SGOH ACQUISITION, INC.
Practice address
912B State Highway 59
Goodman, MO 64843-8252
Phone
(417) 364-7290
NPI assigned
Sep 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

912B State Highway 59
Goodman, MO 64843-8252

Mailing address

912B State Highway 59
Goodman, MO 64843-8252
Phone (417) 364-7290

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170206002308 AR Part A Provider - Rural Health Clinic 5092616276 Practice locations: Goodman, MO

Rural health clinic certification: CCN 268745

Legal name
SGOH ACQUISITION INC
Doing business as
OCH GOODMAN FAMILY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 7, 2015
Last certification
May 19, 2026
Ownership / control type
2B
Most recent change of ownership
Jan 1, 2017 (1 total)
Organization structure
CorporationProprietary
Incorporated
Aug 21, 1991 in MO
Enrollment address
912B State Highway 59
Goodman, MO 64843-8252
Related CCNs
041331, 263885

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
26D0445732Och Goodman Clinic912 State Highway 59, Suite B, Goodman, MO 64843Certificate of waiverMar 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
John D Mackie DO8 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 Corporate DirectorCeo Jan 1, 2017 100%
W-2 Managing EmployeeCeo Jan 1, 2017 100%
Sgoh Acquisition Inc Organization, Gravette, AR Corporation 5% Or Greater Direct Ownership Interest Jan 1, 2017 100%

Owners & managing parties with NPI records 15

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

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 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
Sgoh Acquisition IncRogers, AR, CCN 048529 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control (100%)		 Aug 1, 2020
Aug 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

Practitioners & affiliated clinicians

Practitioners 95

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 95

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1972050581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912B STATE HIGHWAY 59",
            "city": "GOODMAN",
            "state": "MO",
            "postal_code": "648438252",
            "telephone_number": "417-364-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912B STATE HIGHWAY 59",
            "city": "GOODMAN",
            "state": "MO",
            "postal_code": "648438252",
            "telephone_number": "417-364-7290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SGOH ACQUISITION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "417-837-4004",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodman, MO

Sources for this page

Verify at the official NPI Registry.