NPIMap

Organization Active NPI

Icco LLC

Doing business as BestMed

  • Rural Health Clinic/Center
  • Florence, OR
National Provider Identifier
1740896547
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ICCO LLC
Doing business as
BestMed
Practice address
4480 Highway 101 Ste G
Florence, OR 97439-8831
Phone
(458) 215-2185
NPI assigned
Sep 17, 2020
Last updated
Jun 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Authorized official

Name
Erica Hauser
Title
Cfo
Phone
(312) 590-5372

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

4480 Highway 101 Ste G
Florence, OR 97439-8831

Mailing address

PO Box 4858
Portland, OR 97208-4858

Other names 1

  • BestMed Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090218000510 OR Part B Supplier - Clinic/Group Practice 1355406729 Receives reassigned benefits from 316 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bend, OR; Woodburn, OR; Veneta, OR; Springfield, OR; Salem, OR; Roseburg, OR; Redmond, OR; North Bend, OR…

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2910 Santiam Hwy SE
Ste A
Albany, OR 97322
Phone (541) 406-3899

4040 W 11th Ave
Ste B
Eugene, OR 97402
Phone (458) 215-2311

89 Centennial Loop
Eugene, OR 97401
Phone (541) 342-1632

4480 Highway 101
Florence, OR 97439
Phone (541) 902-7627

4480 Highway 101
Ste G
Florence, OR 97439
Phone (458) 215-2185

1890 NW 6th St
Grants Pass, OR 97526
Phone (541) 507-0684

170 N 3rd St
Harrisburg, OR 97446
Phone (541) 998-6750

3400 Cooperative Way
Lebanon, OR 97355
Phone (541) 333-6605

1226 Virginia Ave
North Bend, OR 97459
Phone (541) 305-4224

48134 Highway 58
Oakridge, OR 97463
Phone (541) 556-0525

780 NW Garden Valley Blvd
Roseburg, OR 97471
Phone (541) 672-4885

Practitioners & affiliated clinicians

Practitioners 316

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 316

NPI Registry JSON

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1740896547",
    "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": "4480 HIGHWAY 101 STE G",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974398831",
            "telephone_number": "458-215-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-17",
        "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": "CFO",
        "authorized_official_telephone_number": "312-590-5372"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BestMed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florence, OR

Sources for this page

  • 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.