MEDICARE: SKAGGS COMMUNITY HOSPITAL ASSOCIATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	5248	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871523357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKAGGS COMMUNITY HOSPITAL ASSOCIATION

Provider Business Mailing Address
First Line	:	PO BOX 74111626
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674-5626
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 CAHILL RD
Second Line	:	SUITE 206
City	:	BRANSON
State	:	MO
Zip	:	65616-2036
Country	:	US
Telephone Number	:	417-348-8100
Fax Number	:	417-348-8104

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	WILLIAM MAHONEY
Credential	:
Telephone Number	:	417-335-7270

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	12/19/2025

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