ICCO LLC (NPI# 1528498995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528498995 |
| Entity Type | Organization |
| Organization Name | ICCO LLC |
| Other Organization Name | ROSEBURG URGENT CARE |
| Practice Address |
1740 Nw Goetz St Roseburg OR 97471-1613 |
| Mailing Address |
1292 High St Suite #224 Eugene OR 97401-3238 |
| Practice Telephone | 5413458760 |
| Practice Fax Number | 5413458763 |
| Mailing Telephone | 5416363473 |
| Mailing Fax Number | 5416363480 |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2013-11-20 |
| Authorized Official Name | ALEXANDER K MORLEY (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 5416363473 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
OR | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Roseburg Urgent Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922541184 | Icco LLC | Clinic/Center | 35859 Hwy 58, Pleasant Hill, OR 97455 | 2016-11-21 |
| 1639612880 | Icco LLC | Clinic/Center | 5781 Main Street, Springfield, OR 97478 | 2016-11-21 |
| 1053854208 | Icco LLC | Clinic/Center | 1740 Nw Goetz Street, Roseburg, OR 97471 | 2016-11-21 |
| 1235672478 | Icco LLC | Clinic/Center | 2710 Willamette Street, Eugene, OR 97405 | 2016-11-21 |
| 1922458371 | Icco LLC | Clinic/Center | 420 Smith St, Harrisburg, OR 97446 | 2016-06-16 |
| 1578928818 | Icco LLC | Clinic/Center | 1800 Coburg Road, Eugene, OR 97401 | 2015-12-30 |
| 1700251154 | Icco LLC | Physician Assistant | 1292 High Street, Suite 224, Eugene, OR 97401 | 2015-12-10 |
| 1740896547 | Icco LLC | Clinic/Center | 4480 Highway 101 Ste G, Florence, OR 97439-8831 | 2020-09-17 |
| 1649886441 | Icco LLC | Clinic/Center | 355 W 3rd Ave, Junction City, OR 97448-1313 | 2020-09-17 |
| 1063806842 | Icco LLC | Clinic/Center | 35859 Highway 58, Pleasant Hill, OR 97455-9651 | 2015-03-19 |
| Street Address |
1740 NW GOETZ ST |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97471-1613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760473060 | Kerry Lyn Harrington | Emergency Medicine | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2005-11-04 |
| 1598301582 | James William Southam | Nurse Practitioner | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2019-11-25 |
| 1851937924 | Thanita Pradhanang | Physician Assistant | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2019-11-22 |
| 1467973826 | Jeffrey Samuel Ure | Physician Assistant | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2017-07-06 |
| 1487185393 | April Marie Riverland | Physician Assistant | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2017-03-22 |
| 1184060105 | Jessica Lynn Guido | Nurse Practitioner | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2013-05-16 |
| 1689647927 | Matthew S. Driver | Emergency Medicine | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841805660 | Rae Ann Barnes | Pharmacist | 913 Ne Garden Valley Blvd, Pharmacy, Roseburg, OR 97471 | 2020-09-09 |
| 1023651031 | Colton Phillips | Behavioral Analyst | 940 Nw Garden Valley Bvld #104, Roseburg, OR 97471 | 2019-10-22 |
| 1952884876 | Meredith Krugel Lcsw PC | Clinic/Center | 2225 Nw Stewart Parkway Ste 200, Roseburg, OR 97471 | 2018-09-07 |
| 1114456563 | Philip Kaser Family, LLC | Pharmacy | 1175 W. Harvard Avenue, Roseburg, OR 97471 | 2017-06-08 |
| 1053854208 | Icco LLC | Clinic/Center | 1740 Nw Goetz Street, Roseburg, OR 97471 | 2016-11-21 |
| 1770034589 | Evie Jepsen | Case Manager/Care Coordinator | 2700 Stewart Parkway Annex B, Suite 110, Roseburg, OR 97471 | 2016-10-17 |
| 1932551256 | Jonathan Schmidt | Licensed Practical Nurse | 913 Nm Garden Valley Blvd, Va Roseburg Medical Center, Roseburg, OR 97471 | 2016-07-11 |
| 1932580586 | Jeffrey Mark Wareham | Case Manager/Care Coordinator | 2700 Medical Loop, Annex B, Roseburg, OR 97471 | 2015-06-09 |
| 1558784215 | Ginger Jean Thibedeau | Massage Therapist | 3019 Nw Stewart Parkway, Suite 304 #183, Roseburg, OR 97471 | 2014-01-30 |
| 1427303122 | Karishma Parekh | Internal Medicine | 2460 Nw Stewart Pkwy Ste 103, Roseburg, OR 97471 | 2012-07-18 |
| Find all providers in zip 97471 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730794637 | Praxis Medical Group Inc | Clinic/Center | 2011 4th Street, La Grande, OR 97850 | 2020-09-09 |
| 1821620402 | Praxis Medical Group Inc | Clinic/Center | 2215 Nw Shevlin Park Road, Suite 100, Bend, OR 97703-7195 | 2020-02-11 |
| 1952812687 | Mend Clinic LLC | Clinic/Center | 2936 Commercial St Se, Salem, OR 97302-4552 | 2017-10-20 |
| 1407308125 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 3449 N Anchor Street, Ste 300a, Portland, OR 97217 | 2016-10-28 |
| 1689126302 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 2225 Nw Towncenter Drive, Beaverton, OR 97006 | 2016-10-28 |
| 1215388145 | Family Choice Urgent Care LLC | Clinic/Center | 108 Nw Sisemore St, Suite 120, Bend, OR 97703-2869 | 2016-06-22 |
| 1922458371 | Icco LLC | Clinic/Center | 420 Smith St, Harrisburg, OR 97446 | 2016-06-16 |
| 1710349477 | Uptown Providers PC | Clinic/Center | 14284 Sw Allen Blvd, Beaverton, OR 97005-4405 | 2016-03-22 |
| 1790188043 | Emurgent Care LLC | Clinic/Center | 109b E Ellendale Ave, Dallas, OR 97338-1794 | 2014-10-01 |
| 1134563620 | Uptown Providers Inc | Clinic/Center | 7033 Ne Sandy Blvd, Portland, OR 97213 | 2013-04-26 |
| 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.