Icc Medical LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4074P Issued in KY

Legal business name

ICC MEDICAL LLC

Practice address

405 S L Rogers Wells Blvd
Glasgow, KY 42141-1725

Phone

(270) 834-8892

Fax

(270) 834-8899

NPI assigned

Oct 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Roger Williams, MDNPI 1740230366

Title

Owner

Phone

(270) 834-8892

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roger Todd Williams, MD

  • Family Medicine Physician
  • Cave City, KY
  • NPI 1740230366
  NPD (past) Authorized official

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1376730705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S L ROGERS WELLS BLVD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411725",
            "telephone_number": "270-834-8892",
            "fax_number": "270-834-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 S L ROGERS WELLS BLVD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411725",
            "telephone_number": "270-834-8892",
            "fax_number": "270-834-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICC MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-834-8892",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4074P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danny G Humphrey, LPCC
• Melinda Marie Hunt, P.T.
• Pamela Joann Hunter, LPCA
• Farrell Hurt
• Courtney R Hutchins, LPCC
• Icc Medical LLC
• Inspire Counseling LLC
• Interventional Pain Specialists of Bowling Green, PLC
• Isaiah 43 Christian Counseling Service
• Melanie M Isbell, APRN

• All providers in Glasgow, KY
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.