ICCO, LLC (NPI# 1437660768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437660768 |
| Entity Type | Organization |
| Organization Name | ICCO, LLC |
| Other Organization Name | MUSCULOSKELETAL CLINIC |
| Practice Address |
598 E 13th Ave Eugene OR 97401-4783 |
| Mailing Address |
1292 High St Ste 224 Eugene OR 97401-3238 |
| Practice Telephone | 5418440233 |
| Practice Fax Number | 5415057486 |
| Mailing Telephone | 5412283865 |
| Mailing Fax Number | 5416544693 |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2019-07-16 |
| Authorized Official Name | LORA PETERSON (CLINIC MANAGER) |
| Authorized Official Telephone | 5415418440 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Musculoskeletal Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407004757 | Icco, LLC | Clinic/Center | 4040 W 11th Ave, Eugene, OR 97402-5601 | 2008-08-28 |
| 1518990621 | Icco, LLC | Family Medicine | 87983 Territorial Rd, Veneta, OR 97487 | 2006-07-09 |
| 1083159503 | Icco, LLC | Clinic/Center | 25045 Dunham Avenue, Veneta, OR 97487 | 2016-12-20 |
| 1285176867 | Icco, LLC | Physical Therapist | 1800 Coburg Rd, Eugene, OR 97401-4995 | 2016-11-14 |
| 1528356953 | Icco, LLC | Clinic/Center | 5781 Main St, Springfield, OR 97478-5426 | 2011-07-19 |
| 1528385754 | Icco, LLC | Physical Therapist | 1800 Coburg Rd, Eugene, OR 97401-4995 | 2010-04-28 |
| 1902131022 | Icco, LLC | Clinic/Center | 1800 Coburg Rd, Eugene, OR 97401-4945 | 2009-10-07 |
| 1992861611 | Icco, LLC | Family Medicine | 1800 Coburg Rd, Eugene, OR 97401-4995 | 2006-12-28 |
| Street Address |
598 E 13TH AVE |
| City | EUGENE |
| State | OR |
| Zip Code | 97401-4783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053365627 | Rachel Jean Nosce | Family Medicine | 598 E 13th Ave, Eugene, OR 97401-4783 | 2006-05-19 |
| 1467864017 | Danielle Leah Hirsch | Massage Therapist | 598 E 13th Ave, Eugene, OR 97401-4783 | 2014-05-29 |
| 1275954083 | Brittany Reed | Massage Therapist | 598 E 13th Ave, Ste B, Eugene, OR 97401-4783 | 2013-12-20 |
| 1508134214 | Jessica Nicole Gulovsen | Massage Therapist | 598 E 13th Ave, Suite B, Eugene, OR 97401-4783 | 2011-12-08 |
| 1912292871 | Elyse Rae Jenner | Physical Therapist | 598 E 13th Ave, Eugene, OR 97401-4267 | 2011-06-17 |
| 1861701377 | Andrea Lynette Woodrich | Physical Therapist | 598 E 13th Ave, C/o Eugene Urgent Care, Eugene, OR 97401-4267 | 2010-09-30 |
| 1396054805 | Sandra Arlene Kitzhaber | Physical Therapist | 598 E 13th Ave, C/o Eugene Urgent Care, Eugene, OR 97401-4267 | 2010-09-30 |
| 1740419308 | Dianne T Martin Morley | Physical Therapist | 598 E 13th Ave, Eugene, OR 97401-4267 | 2009-07-03 |
| 1528100310 | Leslie Hoffman | Occupational Therapist | 598 E 13th Ave, Eugene, OR 97401-4267 | 2007-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427681709 | Sarah Voigt | Counselor | 2149 Centennial Plaza Suite #4, Eugene, OR 97401 | 2020-02-14 |
| 1801426242 | Therapeutic Associates, Inc. | Physical Therapist | 760 Charnelton St., Suite 760, Eugene, OR 97401 | 2020-01-24 |
| 1225676232 | Aaron James Barber | Massage Therapist | 1375 Pearl St, Eugene, Or 97401, Eugene, OR 97401 | 2019-12-20 |
| 1851957047 | Altru Home Care LLC | Nursing Care | 1345 Olive St., Eugene, OR 97401 | 2019-05-14 |
| 1881155208 | Herron Jordanna Spence | Speech-Language Pathologist | 385 West 2nd Ave., Eugene, OR 97401 | 2019-03-28 |
| 1750855094 | Brandon Marshall | Counselor | 1158 High St Ste 202, Eugene, OR 97401 | 2019-01-21 |
| 1881172591 | Kayla Nicole O'brien | Nurse Practitioner | Country Club In Eugene, 520 Country Club Road, Eugene, OR 97401 | 2018-08-03 |
| 1962992180 | Shannon Jensen Smyth | Counselor | Va Eugene Downtown Clinic, 211 E. 7th Ave, Eugene, OR 97401 | 2018-05-14 |
| 1902305956 | Christine Noel Gray | Peer Specialist | 499 W. 4th Ave, Eugene, OR 97401 | 2018-02-06 |
| 1821507344 | Anjuli Chitkara | Psychologist | 1679 Willamette Street, Eugene, OR 97401 | 2017-09-27 |
| Find all providers in zip 97401 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477667053 | M Joshua Haber | Family Medicine | 2401 River Rd Ste 101, Eugene, OR 97404-5412 | 2006-08-19 |
| 1962470948 | Gregory C Skaggs | Family Medicine | 2727 Leo Harris Pkwy, Eugene, OR 97401-8835 | 2006-03-08 |
| 1063418838 | Craig J Davidson | Family Medicine | 1232 University of Oregon, Eugene, OR 97403-1232 | 2005-06-24 |
| 1912129610 | Robert V Crist | Family Medicine | 2727 Leo Harris Pkwy, Eugene, OR 97401-8835 | 2007-05-03 |
| 1437273174 | Denise Diane Routhier | Family Medicine | 55 Coburg Rd, Eugene, OR 97401-2433 | 2007-03-19 |
| 1609900893 | Lisa M Pomranky | Family Medicine | 55 Coburg Rd, Slocum Orthopedics PC, Eugene, OR 97401-2433 | 2007-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003085630 | Peter Shelby Bogard Do | Family Medicine | 700 Sw Ramsey, Suite 104, Grants Pass, OR 97527-5788 | 2008-02-28 |
| 1801079074 | Jennifer Dawn Kleinman | Family Medicine | 5704 N Montana Ave, Portland, OR 97217-4643 | 2007-12-11 |
| 1760431175 | Karl Nicholas Kaluza | Family Medicine | 4811 Meadows Rd Ste 101, Lake Oswego, OR 97035-2542 | 2006-05-10 |
| 1871558353 | Douglas Bruce Mckeag | Family Medicine | 4411 Sw Vermont St, Portland, OR 97219-1020 | 2006-04-19 |
| 1356305023 | David N Westerdahl | Family Medicine | 12672 Nw Barnes Rd Ste 100, Portland, OR 97229-6191 | 2006-04-12 |
| 1538138276 | Sekou Carlos Ford | Family Medicine | 18610 Nw Cornell Rd Ste 101, Hillsboro, OR 97124-9206 | 2006-03-15 |
| 1831165232 | Linda Craska Selby | Family Medicine | 384 Se Combs Flat Rd, Prineville, OR 97754-2562 | 2006-02-24 |
| 1811967235 | Charles W Webb | Family Medicine | 1960 Nw 167th Pl Ste 200, Beaverton, OR 97006-4804 | 2006-01-26 |
| 1659374528 | Peter Bogard | Family Medicine | 700 Ramsey Ave, Ste 104, Grants Pass, OR 97527-5788 | 2005-05-24 |
| 1346863727 | Sports Health Northwest Inc | Family Medicine | 12672 Nw Barnes Rd Ste 100, Portland, OR 97229-6191 | 2020-05-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.