ICCO LLC (NPI# 1639612880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639612880 |
| Entity Type | Organization |
| Organization Name | ICCO LLC |
| Other Organization Name | PRIME CARE PARTNERS |
| Practice Address |
5781 Main Street Springfield OR 97478 |
| Mailing Address |
1292 High Street Suite 224 Eugene OR 97401 |
| Practice Telephone | 5416545245 |
| Practice Fax Number | 5418441801 |
| Mailing Telephone | 5412283865 |
| Mailing Fax Number | 5416544693 |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2016-11-21 |
| Authorized Official Name | PEGGY J ANDERSON (BILLING OFFICE MANAGER) |
| Authorized Official Telephone | 5412283865 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | RR MEDICARE PTAN | DP1360 | 01 |
| Other Name | Type Code |
|---|---|
| Prime Care Partners | 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 |
| 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 |
| 1821413881 | Icco LLC | Clinic/Center | 2710 Willamette St, Eugene, OR 97405-3238 | 2014-02-27 |
| Street Address |
5781 MAIN STREET |
| City | SPRINGFIELD |
| State | OR |
| Zip Code | 97478 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588225155 | Mckenzie Dental Center | Dentist | 110 S. 59th St, Springfield, OR 97478 | 2019-06-25 |
| 1831691310 | Michael Ryan Odle | Psychologist | 36716 Oak Point Rd, Springfield, OR 97478 | 2018-03-01 |
| 1639529258 | Nate John Sutherland | Behavioral Analyst | 37770 Upper Creek Road, Springfield, OR 97478 | 2016-06-14 |
| 1457760134 | Leah Rybolt | Physical Therapist | 145 South 52nd Place, Springfield, OR 97478 | 2014-08-07 |
| 1972918423 | Loree Lynn Howard | Case Manager/Care Coordinator | 4145 Jasper Road, Springfield, OR 97478 | 2014-06-24 |
| 1245589753 | Sarah M Boothe | Doula | 870 S 46th St, Springfield, OR 97478 | 2012-08-30 |
| 1902155401 | Dani Maree Hill | Pharmacist | 5744 Main Street, Springfield, OR 97478 | 2012-08-30 |
| 1295005312 | Express Services Unlimited, Inc. | Non-emergency Medical Transport (VAN) | 37506 Hills Creek Road, Springfield, OR 97478 | 2012-01-05 |
| 1255524468 | Leeann D Fields | Licensed Practical Nurse | 3318 Lakeview Dr, Eugene, OR 97478 | 2007-08-21 |
| 1891829172 | Leroy Ernest Roberts | Pharmacist | 38850 Camp Creek Road, Springfield, OR 97478 | 2007-03-16 |
| Find all providers in zip 97478 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730790874 | Janice G. Sadaya-conda M.d., Pllc | Clinic/Center | 6128 Brandon Ave Ste 225, Springfield, VA 22150-2640 | 2020-08-12 |
| 1164841912 | Yellow Springs Primary Care, Inc | Clinic/Center | 2608 E High St, Springfield, OH 45505-1454 | 2014-04-09 |
| 1891125480 | Western Massachusetts Primary Care PC | Clinic/Center | 405 Armory St, Springfield, MA 01104-2305 | 2013-11-18 |
| 1629364351 | Spring Valley Family Care | Clinic/Center | 27 Springfield Pike, Springfield, WV 26763 | 2011-06-21 |
| 1881193670 | 417 Health & Wellness | Clinic/Center | 1850 S Stewart Ave, Springfield, MO 65804-2519 | 2018-02-07 |
| 1588057533 | Quest Primary Care LLC | Clinic/Center | 1176 E Home Rd, Springfield, OH 45503-2726 | 2015-03-16 |
| 1851718712 | Community Health Clinic Pllc | Clinic/Center | 80 Congress St, Springfield, MA 01104-3564 | 2014-03-27 |
| 1518309426 | Burton Hills Primary Care, LLC | Clinic/Center | 2662 Memorial Blvd, Springfield, TN 37172 | 2013-07-19 |
| 1922350099 | Board of Trustees of Southern Illinois University | Clinic/Center | 5220 S 6th Street Rd, Suite 1200, Springfield, IL 62703-5735 | 2012-10-12 |
| 1396097960 | Board of Trustees of Southern Illinois University | Clinic/Center | 520 N 4th St, Springfield, IL 62702-5238 | 2012-10-08 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 97478 |
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.