1. Home
  2. Directory
  3. Arkansas
  4. Rogers
  5. Clinic Center
  6. NPI Profile

OCH BENTON COUNTY CLINIC
NPI 1154945483
Clinic/Center - Rural Health in Rogers, AR

Active since June 02, 2020CLIA 04D2186272 · Waiver
102 RUSSELL ROAD, ROGERS, AR 72756(479) 278-7189(479) 278-2199 Get Directions Write a Review

NPPES record last updated: June 12, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 12, 2020, Jun 2, 2020 (2 updates tracked since 2020).

About Och Benton County Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OCH BENTON COUNTY CLINIC (NPI 1154945483) is a healthcare organization registered as a rural health in Rogers, Arkansas and active in the NPI registry since June 2020. The organization holds a CLIA Waiver certificate valid through June 15, 2028 and lists Paul G Taylor, Ceo, as its authorized official.

NPPES Registry Identity

NPI1154945483
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSGOH ACQUISITION INC
Location Address102 RUSSELL ROADRogers, AR 72756
Mailing Address102 Russell RoadRogers, AR 72756
Phone(479) 278-7189
Fax(479) 278-2199
Organization SubpartNo
Authorized OfficialPaul G TaylorCeo · (417) 837-4004
Enumeration DateJune 2, 2020
Last NPPES UpdateJune 12, 20202 updates tracked since enumeration
NPPES CertifiedJune 12, 2020
✔ NPI 1154945483 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
102 RUSSELL ROAD, Rogers, AR 72756
Open in Google Maps ↗

Other Names 1

Doing Business AsOch Benton County Clinic

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Och Benton County Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateArkansasEnrollment IDO20200617003148Part A · Rural Health ClinicDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D2186272

Och Benton County Clinic · Rogers, AR
Active · expires Jun 15, 2028
CLIA Number04D2186272
Laboratory TypePhysician Office
Certificate Effective DateJune 16, 2026
Certificate Expiration DateJune 15, 2028
Laboratory DirectorDr. Vijay Kannum
Laboratory Phone(479) 278-7189
Laboratory LocationOch Benton County Clinic102 Russell Rd, Rogers, AR 72756
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sgoh Acquisition Inc's NPI number?

The NPI number for Sgoh Acquisition Inc is 1154945483. It was assigned to this organization in the NPPES registry on June 2, 2020. The provider is doing business as Och Benton County Clinic.

Where is Sgoh Acquisition Inc located?

Sgoh Acquisition Inc is located at 102 Russell Road, Rogers, AR 72756. The listed phone number is (479) 278-7189.

What is Sgoh Acquisition Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Is Sgoh Acquisition Inc enrolled in Medicare?

Yes. Sgoh Acquisition Inc is registered in the Medicare PECOS enrollment system.

When is Sgoh Acquisition Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this organization (Arkansas, Rural Health Clinic) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Sgoh Acquisition Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2186272) is associated with this NPI, valid through June 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sgoh Acquisition Inc accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 2 other insurers list Sgoh Acquisition Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sgoh Acquisition Inc was last updated on June 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.