OrganizationActive
Icdoc LLC
NPI 1629756929 · Primary Care Clinic/Center · Poplar Bluff, MO
Icdoc LLC is a Primary Care Clinic/Center organization in Poplar Bluff, MO (NPI 1629756929).
Provider details
- NPI number
- 1629756929
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Shelly Gresham, Member, Administrator(573) 776-0157
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 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
2445 N Westwood Blvd Ste 100
Poplar Bluff, MO 63901-2317
Phone: (573) 776-0157
Street-level locationGet directions
Mailing address
2445 N Westwood Blvd Ste 100
Poplar Bluff, MO 63901-2317
Registry dates
- Enumerated
- 2023-07-06
- Last updated
- 2023-07-06
- Certified
- 2023-07-06
Frequently asked questions
- What is Icdoc LLC's NPI number?
- Icdoc LLC's National Provider Identifier (NPI) is 1629756929, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Icdoc LLC?
- Icdoc LLC is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Icdoc LLC located?
- Icdoc LLC's practice location on file with NPPES is 2445 N Westwood Blvd Ste 100, Poplar Bluff, MO 63901-2317.
- What is Icdoc LLC's phone number?
- The practice phone number listed in the NPPES registry for Icdoc LLC is (573) 776-0157.
- Who is the authorized official for Icdoc LLC?
- The authorized official listed on Icdoc LLC's NPPES record is Shelly Gresham, Member, Administrator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Icdoc LLC's NPI active?
- Yes — Icdoc LLC's NPI (1629756929) is active in the NPPES registry as of the last update on 2023-07-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.