Icdoc LLC

Icdoc LLC is a healthcare organization registered as Primary Care Clinic/Center in Poplar Bluff, MO, holding Type 2 (organization) NPI 1629756929 since 2023. The authorized official on file is Shelly Gresham, Member, Administrator.

✓ Active NPI ✓ Valid NPI checksum

NPI	1629756929
Entity type	Organization (Type 2)
Legal business name	Icdoc LLC
Practice address	2445 N WESTWOOD BLVD STE 100, Poplar Bluff, MO, 63901
Phone	5737760157
Enumeration date	2023-07-06
Last updated in NPPES	2023-07-06

Authorized official

Name	Shelly Gresham
Title	Member, Administrator
Phone	5737760157

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
261QP2300X	Primary Care Clinic/Center	Primary	—	—

Copy-ready billing details

Provider: Icdoc LLC
NPI: 1629756929
Taxonomy: 261QP2300X (Primary Care Clinic/Center)
Address: 2445 N WESTWOOD BLVD STE 100, Poplar Bluff, MO, 63901

Providers at this address

NPI	Name	Type	Specialty	Location
1841226222	Kip Newell	Individual	Anesthesiology Physician	Poplar Bluff, MO

Verify this record

Cross-check NPI 1629756929 against the authoritative CMS record: view Icdoc LLC 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

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2023-07-06. Verify at npiregistry.cms.hhs.gov.

Where is Icdoc LLC located?

The practice location on file with NPPES is in Poplar Bluff, MO.

Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2023-07-06.