Iccabi LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

ICCABI LLC

Practice address

1458 Ridgeway Drive
Jeffersonville, IN 47130

Phone

(812) 647-7960

NPI assigned

Nov 16, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Tyre Grinage

Title

Ceo

Phone

(812) 647-7960

Specialties & licenses 1

Addresses

Other names 1

• PRIVATE RIDES Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1063287449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1458 RIDGEWAY DR",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471306174",
            "telephone_number": "812-647-7960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1458 RIDGEWAY DRIVE",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "47130",
            "telephone_number": "812-647-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICCABI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-16",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "GRINAGE",
        "authorized_official_first_name": "TYRE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-647-7960",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIVATE RIDES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marcy Huning, RBT, BS
• Olesya Hunter, MS, RD, LD
• Caylee Hurlburt, RBT
• Makayla Elizabeth Hurst, DPT
• I Transport Nemt
• Olegario J Ignacio Jr., MD
• Indiana Center for Recovery Outpatient Services LLC
• Infectious Diseases Specialists of Kentuckiana LLC
• Lakhwinder Insan, APRN
• Constance Lee Isaacs, RBT

• Non-emergency Medical Transport (VAN) in Jeffersonville, IN
• Providers in Jeffersonville, IN by specialty
• Non-emergency Medical Transport (VAN) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.