ICCO LLC (NPI# 1649886441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649886441 |
| Entity Type | Organization |
| Organization Name | ICCO LLC |
| Practice Address |
355 W 3rd Ave Junction City OR 97448-1313 |
| Mailing Address |
Po Box 824 Springfield OR 97477-0141 |
| Practice Telephone | 4582152189 |
| Mailing Telephone | 5412283865 |
| Mailing Fax Number | 5416544693 |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |
| Authorized Official Name | MRS. AMELIA D LEDBETTER (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 5733354715 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Nova Health | 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 |
| 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 |
355 W 3RD AVE |
| City | JUNCTION CITY |
| State | OR |
| Zip Code | 97448-1313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366542847 | James William Martin | Internal Medicine | 355 W 3rd Ave, Junction City, OR 97448-1313 | 2006-09-24 |
| 1720553522 | Joshua Ryan Nicholson | Physician Assistant | 355 W 3rd Ave, Junction City, OR 97448-1313 | 2018-10-08 |
| 1710406012 | Camille Ellen Pincock | Physician Assistant | 355 W 3rd Ave, Junction City, OR 97448-1313 | 2017-09-18 |
| 1790200947 | Laboratory Corporation of America | Clinical Medical Laboratory | 355 W 3rd Ave, Junction City, OR 97448-1313 | 2017-08-09 |
| 1003195389 | Trina J Viner | Physician Assistant | 355 W 3rd Ave, Junction City, OR 97448-1313 | 2011-08-04 |
| 1528374915 | Laurel Vecsey | Physical Therapist | 355 W 3rd Ave, Junction City, OR 97448-1313 | 2010-08-24 |
| 1053638536 | Haiyun Ellina Ma | Nurse Practitioner | 355 W 3rd Ave, Junction City, OR 97448-1313 | 2010-04-23 |
| 1104097054 | Junction City Medical Clinic, P.C. | Non-Pharmacy Dispensing Site | 355 W 3rd Ave, Junction City, OR 97448-1313 | 2008-03-19 |
| 1003036757 | Cynthia Jean Smith | Nurse Practitioner | 355 W 3rd Ave, Junction City, OR 97448-1313 | 2007-04-26 |
| 1710043427 | Arthur J Willey | Family Medicine | 355 W 3rd Ave, Junction City, OR 97448-1313 | 2006-12-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083246466 | Haley Forte | Specialist/Technologist | 408 Walnut Street, Junction City, OR 97448 | 2020-02-04 |
| 1255841250 | Joann M Hatton | Counselor | 1041 Yew St, Junction City, OR 97448 | 2017-10-04 |
| 1437605482 | Terry Zachariah Hurst | Social Worker | 92695 Pebble Beach Lane, Junction City, OR 97448 | 2016-08-30 |
| 1568806206 | Devon Denny | Occupational Therapist | 503 S Birch St, Junction City, OR 97448 | 2013-04-24 |
| 1518923200 | Paulette Ann Richards | Rehabilitation Practitioner | 24820 Paradise Drive, Junction City, OR 97448 | 2006-04-22 |
| 1033717624 | Therapy To Shine | Clinic/Center | 210 E 6th Ave, Junction City, OR 97448 | 2020-10-15 |
| 1497392591 | Jenny Mayer Chan | Pharmacist | 1755 Ivy St, Junction City, OR 97448 | 2019-12-08 |
| 1275922239 | Oregon State Hospital - Junction City Campus | Pharmacy | 29398 Recovery Way, Junction City, OR 97448 | 2015-01-14 |
| 1396142543 | Ruth Will | Physical Therapist | 680 Ivy St, Junction City, OR 97448 | 2014-12-02 |
| 1144399213 | Michael Howard Baum | Physical Therapist | 321 Holly Street, Junction City, OR 97448-0275 | 2006-11-06 |
| Find all providers in zip 97448 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770183063 | Praxis Medical Group P.C. | Clinic/Center | 1890 7th St., Umatilla, OR 97882 | 2020-10-27 |
| 1336749621 | Praxis Medical Group P.C. | Clinic/Center | 2011 Fourth St., La Grande, OR 97850 | 2020-10-27 |
| 1225694706 | Columbia Lutheran Charities | Clinic/Center | 1111 N Roosevelt Dr Ste 210, Seaside, OR 97138-4604 | 2019-05-10 |
| 1093296519 | Grande Ronde Hospital, Inc. | Clinic/Center | 10303 S Walton Rd, La Grande, OR 97850 | 2018-08-23 |
| 1285164921 | Northwest Medical Foundation of Tillamook | Clinic/Center | 1005 Cougar St, Vernonia, OR 97064-1282 | 2017-06-15 |
| 1043694342 | Grande Ronde Hospital, Inc | Clinic/Center | 570 8th, Elgin, OR 97827 | 2015-07-16 |
| 1992183859 | Centennial Medical Group East, LLC | Clinic/Center | 145 E. Broadway, Myrtle Creek, OR 97457 | 2015-05-12 |
| 1477945517 | Morrow County Health District | Clinic/Center | 365 W 3rd St, Ione, OR 97843-7216 | 2015-02-26 |
| 1699183236 | Lake Health District | Clinic/Center | 700 South J St, Lakeview, OR 97630 | 2014-07-28 |
| 1487919783 | Aurora Family Health and Maternity Care Services LLC | Clinic/Center | 21358 Hwy 99e Ne, Aurora, OR 97002 | 2012-07-12 |
| Find all providers with the same taxonomy | ||||
| City | JUNCTION CITY |
| Zip Code | 97448 |
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.