Active NPI
Icco LLC
Doing business as BestMed
- Primary Care Clinic/Center
- Roseburg, OR
National Provider Identifier
1053854208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- ICCO LLC
- Doing business as
- BestMed
- Practice address
- 1740 NW Goetz Street
Roseburg, OR 97471 - Phone
- (541) 672-4885
- Fax
- (541) 672-4782
- NPI assigned
- Nov 21, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Peggy J Anderson
- Title
- Billing Manager
- Phone
- (541) 672-4885
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Primary |
Addresses
Primary practice location
1740 NW Goetz Street
Roseburg, OR 97471
Mailing address
1292 High Street
Suite 224
Eugene, OR 97401
Phone (541) 228-3865
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DP1360 | Other | OR | RR MEDICARE PTAN |
Other names 1
- BestMed
National Provider Directory
National Provider Directory- Tax ID family
- Icco LLC
Other organizations with this tax ID 14
Organizations that report the same tax identification number in the National Provider Directory.
-
- Primary Care Clinic/Center
- Eugene, OR
- NPI 1821549536
-
dba Pleasant Hill Medical Clinic
- Primary Care Clinic/Center
- Pleasant Hill, OR
- NPI 1922541184
-
dba Musculoskeletal Clinic
- Sports Medicine (Family Medicine) Physician
- Eugene, OR
- NPI 1437660768
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479686400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1655683200000",
"number": "1053854208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1292 HIGH STREET",
"address_2": "SUITE 224",
"city": "EUGENE",
"state": "OR",
"postal_code": "97401",
"telephone_number": "541-228-3865",
"fax_number": "541-654-4693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 NW GOETZ STREET",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "97471",
"telephone_number": "541-672-4885",
"fax_number": "541-672-4782"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ICCO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-11-21",
"last_updated": "2022-06-20",
"certification_date": "2022-06-20",
"status": "A",
"authorized_official_last_name": "ANDERSON",
"authorized_official_first_name": "PEGGY",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "541-672-4885"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PTAN",
"identifier": "DP1360",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "BestMed",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.