NPIMap

Organization Active NPI

Icco LLC

  • Urgent Care Clinic/Center
  • Roseburg, OR
National Provider Identifier
1528498995
Registry record updated Nov 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
ICCO LLC
Doing business as
Roseburg Urgent Care
Practice address
1740 NW Goetz St
Roseburg, OR 97471-1613
Phone
(541) 345-8760
Fax
(541) 345-8763
NPI assigned
Nov 20, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2013

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

Authorized official

Name
Alexander K Morley, MD
Title
Medical Director
Phone
(541) 636-3473

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X OR Primary

Addresses

Primary practice location

1740 NW Goetz St
Roseburg, OR 97471-1613

Mailing address

1292 High St
Suite #224
Eugene, OR 97401-3238
Phone (541) 636-3473

Other names 1

  • Roseburg Urgent Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Icco LLC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1384905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384905600000",
    "number": "1528498995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1292 HIGH ST",
            "address_2": "SUITE #224",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013238",
            "telephone_number": "541-636-3473",
            "fax_number": "541-636-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 NW GOETZ ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711613",
            "telephone_number": "541-345-8760",
            "fax_number": "541-345-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-20",
        "last_updated": "2013-11-20",
        "status": "A",
        "authorized_official_last_name": "MORLEY",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "541-636-3473",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roseburg Urgent Care",
            "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 Nov 20, 2013; 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.