Icp Ppo, LLC
NPI 1407443617 · Preferred Provider Organization · South Bend, IN
Icp Ppo, LLC is a Preferred Provider Organization organization in South Bend, IN (NPI 1407443617).
Provider details
- NPI number
- 1407443617
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Kelly Macken - Marble, President(218) 393-1566
Specialties & taxonomies
Managed Care Organizations
- Specialist174400000X
Other Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2020-12-22
- Last updated
- 2020-12-22
- Certified
- 2020-12-22
Frequently asked questions
- What is Icp Ppo, LLC's NPI number?
- Icp Ppo, LLC's National Provider Identifier (NPI) is 1407443617, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Icp Ppo, LLC?
- Icp Ppo, LLC is classified in the NPPES registry as Preferred Provider Organization (Managed Care Organizations).
- Where is Icp Ppo, LLC located?
- Icp Ppo, LLC's practice location on file with NPPES is 211 N Eddy St, South Bend, IN 46617-2808.
- What is Icp Ppo, LLC's phone number?
- The practice phone number listed in the NPPES registry for Icp Ppo, LLC is (574) 234-8161.
- Who is the authorized official for Icp Ppo, LLC?
- The authorized official listed on Icp Ppo, LLC's NPPES record is Kelly Macken - Marble, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Icp Ppo, LLC's NPI active?
- Yes — Icp Ppo, LLC's NPI (1407443617) is active in the NPPES registry as of the last update on 2020-12-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.