ICP PPO, LLC
NPI 1407443617
Preferred Provider Organization in South Bend, IN
NPI Status: Active since December 22, 2020
Contact Information
211 N EDDY ST
SOUTH BEND, IN
ZIP 46617
Phone: (574) 234-8161
- Organization
- Preferred Provider Organization
About ICP PPO, LLC
This page provides the complete NPI Profile along with additional information for Icp Ppo, Llc, a provider established in South Bend, Indiana operating as a Preferred Provider Organization. The healthcare provider is registered in the NPI registry with number 1407443617 assigned on December 2020. The practitioner's primary taxonomy code is 305R00000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. Icp Ppo, Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Kelly Macken - Marble (President)
- NPI
- 1407443617
- Provider Name
- ICP PPO, LLC
- Entity Type
- Organization
- Location Address
- 211 N EDDY ST SOUTH BEND, IN 46617
- Location Phone
- (574) 234-8161
- Mailing Address
- 413 W MONTGOMERY XRD STE 602 SAVANNAH, GA 31406
- Mailing Phone
- (912) 691-5711
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-22-2020
- Last Update Date
- 12-22-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Preferred Provider Organization
- Taxonomy Code
- 305R00000X
- Type
- Managed Care Organizations
- Taxonomy Description
- A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 174400000X | Other Service Providers | Specialist |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1407443617, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SOUTH BEND, IN 46617
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1407443617, enumerated as an "organization" on December 22, 2020.
The provider is located at 211 N EDDY ST SOUTH BEND, IN 46617 and the phone number is (574) 234-8161.
Preferred Provider Organization with taxonomy code 305R00000X.
