ICCO LLC (NPI# 1700251154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700251154 |
| Entity Type | Organization |
| Organization Name | ICCO LLC |
| Other Organization Name | EUGENE URGENT CARE |
| Practice Address |
1292 High Street Suite 224 Eugene OR 97401 |
| Mailing Address |
1292 High St Suite 224 Eugene OR 97401-3238 |
| Practice Telephone | 5413458760 |
| Practice Fax Number | 5413458763 |
| Mailing Telephone | 5413452860 |
| Mailing Fax Number | 5413458763 |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2015-12-10 |
| Authorized Official Name | SUSAN LAVERN HUNSUCKER (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 5415217222 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA175527 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OREGON MEDICAL BOARD STATE LICENSE FOR PHYSICIAN ASSISTANT | PA175527 | 01 |
| Other Name | Type Code |
|---|---|
| Eugene Urgent Care | Former Legal Business 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 |
| 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 |
| 1821413881 | Icco LLC | Clinic/Center | 2710 Willamette St, Eugene, OR 97405-3238 | 2014-02-27 |
| Street Address |
1292 HIGH STREET SUITE 224 |
| City | EUGENE |
| State | OR |
| Zip Code | 97401 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023483419 | Nathaniel J Collins | Physician Assistant | 1292 High St, Suite 224, Eugene, OR 97401 | 2015-12-10 |
| 1972875334 | Travis Matsumoto | Physician Assistant | 920 Country Club Rd Ste 200a, Eugene, OR 97401-6086 | 2012-02-01 |
| 1801060645 | Christine Whitaker | Physician Assistant | 2868 Williamette St #100, Village Health Clinic, Eugene, OR 97405 | 2008-04-14 |
| 1962515213 | Jennifer L. Kalata | Physician Assistant | 2911 Tennyson Ave Ste 201, Eugene, OR 97408 | 2006-08-17 |
| 1780609016 | Steven Hillyer | Physician Assistant | 360 S Garden Way Ste 101, Eugene, OR 97401-8034 | 2006-07-13 |
| 1518934751 | Regina M. Fiacco | Physician Assistant | 890 River Rd, Eugene, OR 97404-3233 | 2006-03-07 |
| 1154306199 | Karen A Beer | Physician Assistant | 600 Country Club Rd, Eugene, OR 97401-2240 | 2005-12-13 |
| 1891247078 | Riccara Wright | Physician Assistant | 1800 Coburg Rd, Eugene, OR 97401-4995 | 2016-11-04 |
| 1295138444 | Jennifer Fisher | Physician Assistant | 1255 Hilyard St, Eugene, OR 97401-3718 | 2014-10-02 |
| 1376884304 | Sagen Castellanos Olson | Physician Assistant | 890 River Rd, Eugene, OR 97404-3233 | 2013-03-15 |
| Find all providers in EUGENE | ||||
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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.