I C CARE CORPORATION (NPI# 1104845361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104845361 |
| Entity Type | Organization |
| Organization Name | I C CARE CORPORATION |
| Practice Address |
1100 Mercantile Ln Suite #135 Largo MD 20774-5380 |
| Practice Telephone | 3017739700 |
| Practice Fax Number | 3017734900 |
| Mailing Telephone | 3017739700 |
| Mailing Fax Number | 3017734900 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2011-10-25 |
| Authorized Official Name | DR. GEORGE HERBERT BONE (OWNER) |
| Authorized Official Telephone | 3017739700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| Y | 174400000X | Specialist | D31069 | MD | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 409341100 | 05 |
| Street Address |
1100 MERCANTILE LN SUITE #135 |
| City | LARGO |
| State | MD |
| Zip Code | 20774-5380 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528028297 | George Herbert Bone | Internal Medicine | 1100 Mercantile Ln, Suite 135, Largo, MD 20774-5380 | 2006-03-25 |
| 1376827337 | Arlene L Murray, Md Pa | Ophthalmology | 1100 Mercantile Ln, Suite #136, Largo, MD 20774-5380 | 2011-10-07 |
| 1033434808 | Diagnostic Imaging, LLC | Radiology | 1100 Mercantile Ln, Suite 150, Largo, MD 20774-5380 | 2010-04-05 |
| 1285834143 | Justin Adrian Robinson | Physical Therapy Assistant | 1100 Mercantile Ln, Largo, MD 20774-5380 | 2007-07-19 |
| 1669696654 | Mitchellville Radiology | Radiology | 1100 Mercantile Ln, Suite 150, Largo, MD 20774-5380 | 2007-04-12 |
| 1376622704 | Arlene Louise Murray | Ophthalmology | 1100 Mercantile Ln, Ste. 136, Largo, MD 20774-5380 | 2006-11-05 |
| 1073616652 | Surendra M Kumar | Family Medicine | 1100 Mercantile Ln, Ste 135, Largo, MD 20774-5380 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922637156 | Marie Charlotte Teboutsou Tsodzou | Nurse Practitioner | 9317 Lavall Drive, Upper Marlboro, MD 20774 | 2020-04-08 |
| 1467093443 | Richland Support Services Corp. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11551 Joyceton Drive, Upper Marlboro, MD 20774 | 2019-10-01 |
| 1770134124 | Alan L Kahn | Counselor | 301 Largo Rd., Largo, MD 20774 | 2019-09-26 |
| 1619522034 | Francisca Ifeoma Alintah | Registered Nurse | 511 Dennis Magruder Dr., Upper Marlboro, MD 20774 | 2019-08-02 |
| 1609337146 | Crystal Osuchukwu | Counselor | 1300 Mccormick Dr, Upper Marlboro, MD 20774 | 2019-03-27 |
| 1861968489 | Collaborative Concepts of Maryland | Counselor | 1400 Mercantile Lane, Suite 208, Largo, MD 20774 | 2018-10-22 |
| 1073097622 | Triple Angels Homecare Services, Inc. | In Home Supportive Care | 1210 Dixie Bowie Way, Upper Marlboro, MD 20774 | 2018-09-19 |
| 1922589654 | Optimum Resource Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 711 Harry S. Truman Dr, Unit #105, Largo, MD 20774 | 2018-08-21 |
| 1811475254 | Kolawole Richard Olatunde | Home Health Aide | 11405 Villa Court, Upper Marlboro, MD 20774 | 2018-07-28 |
| 1548747769 | Tiara Williams | Counselor | 15207 Harriet Clotilda Way, Upper Marlboro, MD 20774 | 2018-07-20 |
| Find all providers in zip 20774 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598108706 | Kristin Woodward | Specialist | 1754 Indian Rocks Rd S, Largo, FL 33774-1027 | 2013-04-08 |
| 1093077711 | Betty Jakubik-randolph | Specialist | 740 13th Ave Sw, Largo, FL 33770-4442 | 2012-06-08 |
| 1891021713 | Frenchie Cooke Barron | Specialist | 8799 Bardmoor Blvd, #104, Largo, FL 33777-2236 | 2009-10-28 |
| 1043457666 | J. Paonessa M.d. P.a. | Specialist | 100 Highland Ave N, Largo, FL 33770-2542 | 2009-01-20 |
| 1689823031 | John Sellers | Specialist | 3497 19th Pl Sw, Largo, FL 33774-1139 | 2008-09-10 |
| 1043498934 | Kendall Bruce Eckert | Specialist | 4209 Imperial Palm Ct, Largo, FL 33771-1616 | 2008-02-04 |
| 1740319268 | Guy P Lafond | Specialist | 220 Poinciana Ln, Largo, FL 33770-2615 | 2007-03-02 |
| 1699840884 | Stephen T Duvall | Specialist | 333 16th Ave Se, Largo, FL 33771 | 2006-11-22 |
| 1457437055 | Michael King Jason | Specialist | 8839 Bryan Dairy Rd, Suite 300, Largo, FL 33777-1203 | 2006-10-27 |
| 1184711939 | Carol Jean Schultz | Specialist | 13300 Walsingham Road, # 85, Largo, FL 33774 | 2006-10-05 |
| Find all providers in LARGO | ||||
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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.