ICC MEDICAL LLC
NPI 1376730705
Nurse Practitioner - Family in Glasgow, KY

Q: What is Icc Medical LLC's NPI number?

The NPI number for Icc Medical LLC is 1376730705. It was assigned to this organization in the NPPES registry on October 1, 2007.

Q: What is Icc Medical LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Icc Medical LLC was last updated on October 1, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 01, 2007

405 S L ROGERS WELLS BLVD, GLASGOW, KY 42141(270) 834-8892(270) 834-8899 Get Directions Write a Review

NPPES record last updated: October 1, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Icc Medical Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ICC MEDICAL LLC (NPI 1376730705) is a healthcare organization registered as a family in Glasgow, Kentucky and active in the NPI registry since October 2007. The organization lists Roger Williams, Owner, as its authorized official.

NPPES Registry Identity

NPI1376730705

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameICC MEDICAL LLC

Location Address405 S L ROGERS WELLS BLVDGlasgow, KY 42141-1725

Mailing Address405 S L Rogers Wells BlvdGlasgow, KY 42141-1725 · (270) 834-8892 · Fax (270) 834-8899

Phone(270) 834-8892

Fax(270) 834-8899

Organization SubpartNo

Authorized OfficialRoger WilliamsOwner · (270) 834-8892

Enumeration DateOctober 1, 2007

✔ NPI 1376730705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in KY · 4074P

405 S L ROGERS WELLS BLVD, Glasgow, KY 42141

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Other Identifiers 1

Medicare PIN00172KY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES M RYNERSON, MD, PSC

Ophthalmology