ICCO LLC (NPI# 1750492906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750492906 |
| Entity Type | Organization |
| Organization Name | ICCO LLC |
| Other Organization Name | COTTAGE GROVE URGENT CARE |
| Practice Address |
1445 Gateway Blvd Cottage Grove OR 97424-1224 |
| Mailing Address |
1292 High Street Suite 224 Eugene OR 97401 |
| Practice Telephone | 5419427000 |
| Practice Fax Number | 5419425550 |
| Mailing Telephone | 5416416053 |
| Mailing Fax Number | 5414859987 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | ALEXANDER K MORLEY (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 5416416053 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | PA00462 | OR | Ambulatory Health Care Facilities |
| N | 261Q00000X | Clinic/Center | MD10106 | OR | Ambulatory Health Care Facilities |
| N | 261Q00000X | Clinic/Center | PA01017 | OR | Ambulatory Health Care Facilities |
| Y | 261Q00000X | Clinic/Center | MD25942 | OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 150890 | 05 | |
| OR | BLUE CROSS/BLUE SHIELD | 06691900 | 01 |
| Other Name | Type Code |
|---|---|
| Cottage Grove Medical Clinic | Doing Business As Name - Organization |
| Cottage Grove 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 |
1445 GATEWAY BLVD |
| City | COTTAGE GROVE |
| State | OR |
| Zip Code | 97424-1224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093714701 | Nancy J Worley | Physical Medicine & Rehabilitation | 1445 Gateway Blvd, Suite D, Cottage Grove, OR 97424 | 2005-07-15 |
| 1255683140 | Martin Roco | Nurse Practitioner | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2012-10-03 |
| 1891070207 | Devon E. Schneider | Nurse Practitioner | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2011-10-17 |
| 1578880548 | Larry Arthur Jackson | Family Medicine | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2010-04-29 |
| 1609068998 | Covered Bridge Physical Therapy LLC | Clinic/Center | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2007-08-10 |
| 1720152465 | Ben Douglas Johnson | Physician Assistant | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2006-11-17 |
| 1932281656 | William Vogel | Physician Assistant | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2006-10-20 |
| 1407872815 | Diana L. V. Knee | Social Worker | 1445 Gateway Blvd, Suite A, Cottage Grove, OR 97424-1224 | 2006-07-15 |
| 1326085846 | Mary Ruth | Nurse Practitioner | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2006-06-01 |
| 1225001720 | Judith Dolene Stensland | Family Medicine | 1445 Gateway Blvd, Cottage Grove, OR 97424-1224 | 2006-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851936157 | Naomi Higgs | Physical Therapy Assistant | 515 Grant St, Cottage Grove, OR 97424 | 2019-11-10 |
| 1588131296 | Home Town Drugs of Cottage Grove, Inc. | Pharmacy | 1205 Hwy 99 North, Cottage Grove, OR 97424 | 2018-10-31 |
| 1215420625 | Zachary Booth | Student in an Organized Health Care Education/Training Program | 28188 Cottage Grove Lorane Rd, Cottage Grove, OR 97424 | 2018-06-11 |
| 1124404090 | Eileen Nittler | Social Worker | 1345 Birch Avenue, Cottage Grove, OR 97424 | 2015-08-03 |
| 1851799787 | Kathryn Brooks | Licensed Practical Nurse | 520 Patrick Loop, Cottage Grove, OR 97424 | 2014-12-09 |
| 1558767814 | Michele Renee Savage | Orthotic Fitter | 148 Gateway Blvd, Cottage Grove, OR 97424 | 2014-11-14 |
| 1730598558 | John Mansfield | Pharmacist | 120 Andrew Drive, Cottage Grove, OR 97424 | 2014-08-06 |
| 1700213493 | Aspen Injury Center LLC | Chiropractor | 1260 East Main Street, Cottage Grove, OR 97424 | 2013-09-26 |
| 1609172956 | Megan Olds | Counselor | 37 South 6th Street, Cottage Grove, OR 97424 | 2011-02-03 |
| 1144530726 | Monica G Radley | Counselor | 1345 Birch Ave., Cottage Grove, OR 97424 | 2010-10-15 |
| Find all providers in zip 97424 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891270211 | Planned Parenthood of Southwestern Oregon | Clinic/Center | 1450 Birch Ave, Cottage Grove, OR 97424-1417 | 2018-10-02 |
| 1568768919 | Allina Health System | Clinic/Center | 8611 W Point Douglas Rd S, Cottage Grove, MN 55016-4005 | 2011-02-02 |
| 1821307224 | Avanti Medical Group of Minnesota LLC | Clinic/Center | 8690 E Point Douglas Rd S, Cottage Grove, MN 55016-4007 | 2010-10-02 |
| 1093996241 | The Village Therapy and Development Center LLC | Clinic/Center | 7249 65th St S, Cottage Grove, MN 55016-1128 | 2007-11-15 |
| 1487784500 | Planned Parenthood of Southwestern Oregon | Clinic/Center | 1450 Birch Ave, Cottage Grove, OR 97424-1417 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932715935 | J.w. Smith, D.c., LLC | Clinic/Center | 4747 S 6th St Ste 2, Klamath Falls, OR 97603-4993 | 2020-09-16 |
| 1427662204 | Edmund H. Torkelson Do, PC | Clinic/Center | 1960 Nw 167th Pl Ste 204, Beaverton, OR 97006-4804 | 2020-08-31 |
| 1134746589 | Redmond Veterinary Clinic PC | Clinic/Center | 1785 Nw 6th St, Redmond, OR 97756-1204 | 2020-07-01 |
| 1801413240 | Gfm LLC | Clinic/Center | 1235 Se Division St Ste 114, Portland, OR 97202-1042 | 2020-07-01 |
| 1184240277 | Evans & Company Healthcare PC | Clinic/Center | 2330 Morada Ln, Ashland, OR 97520-3641 | 2020-06-24 |
| 1427674324 | Northwest Pain Institute | Clinic/Center | 2005 Cedar St, Forest Grove, OR 97116-1701 | 2020-06-17 |
| 1275168759 | Metatron Health LLC | Clinic/Center | 6464 Sw Borland Rd Ste C3, Tualatin, OR 97062-8856 | 2020-03-05 |
| 1427680057 | Ortc, LLC | Clinic/Center | 750 Biddle Rd Ste 102, Medford, OR 97504-6178 | 2020-02-11 |
| 1134750037 | Legacy Good Samaritan Hospital and Medical Center | Clinic/Center | 1040 Nw 22nd Ave Ste 250, Portland, OR 97210-3057 | 2020-01-29 |
| 1861038382 | Clackamas County | Clinic/Center | 2051 Kaen Rd Ste 210, Oregon City, OR 97045-4035 | 2019-11-19 |
| Find all providers with the same taxonomy | ||||
| City | COTTAGE GROVE |
| Zip Code | 97424 |
Please comment or provide details below to improve the information on ICCO LLC.
| 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.