Icco, LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

ICCO, LLC

Practice address

1445 Gateway Blvd
Cottage Grove, OR 97424-1224

Phone

(541) 942-7000

Fax

(541) 998-4571

NPI assigned

Mar 22, 2021

Organization subpart

No

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

Authorized official

Name

Erica Hauser

Title

Director

Phone

(312) 590-5372

Specialties & licenses 1

Addresses

Other names 1

• BestMed Doing business as

Locations

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1336725233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4858",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 GATEWAY BLVD",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974241224",
            "telephone_number": "541-942-7000",
            "fax_number": "541-998-4571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-22",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "HAUSER",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "312-590-5372"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BestMed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chelsie Maegan Hugo
• Daisy B Hurst, MSW, QMHP
• Jared Hutchins, ATC
• McKinley Marie Hutchison, FNP
• Icco LLC
• Interior Intentions (Dba In2Aging
• Larry Arthur Jackson, M.D.
• Keisha Janney
• Shaunna Jennings, RDH
• Pearl Ann Jobe, PMHNP

• Rural Health Clinic/Center in Cottage Grove, OR
• Providers in Cottage Grove, OR by specialty
• Rural Health Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.

Verify at the official NPI Registry.