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Icn Pllc

Icn Pllc is a healthcare organization registered as Clinical Neuropsychologist in Boulder, CO, holding Type 2 (organization) NPI 1487192076 since 2017. The authorized official on file is Bobby Gant, President.

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NPI 1487192076
Entity type Organization (Type 2)
Legal business name Icn Pllc
Other name <Unavail>
Practice address 255 CANYON BLVD STE 300-F, Boulder, CO, 80302
Phone 9725708200
Fax 9724025621
Enumeration date 2017-02-03
Last updated in NPPES 2019-01-02

Authorized official

Name Bobby Gant
Title President
Phone 7205522995

Taxonomy & classification

Taxonomy code Specialty Primary License State
103G00000X Clinical Neuropsychologist Primary 2998 CO

Other identifiers

Identifier Type State Issuer
9000167953 Medicaid CO
Copy-ready billing details
Provider: Icn Pllc
NPI: 1487192076
Taxonomy: 103G00000X (Clinical Neuropsychologist)
Address: 255 CANYON BLVD STE 300-F, Boulder, CO, 80302

Verify this record

Cross-check NPI 1487192076 against the authoritative CMS record: view Icn Pllc on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Icn Pllc?
Icn Pllc is registered in NPPES as a Clinical Neuropsychologist (its primary provider taxonomy).

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2019-01-02.