Individual provider Active NPI

Lanny R. South, DO

  • Anesthesiology Physician
  • Frankfort, IL
National Provider Identifier
1215996582
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036.131960 Issued in IL
Practice address
21120 Washington Pkwy
Frankfort, IL 60423-3112
Phone
(815) 469-9750
NPI assigned
Mar 23, 2006
Last updated
Oct 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X OS7770 FL
Anesthesiology Physician 207L00000X 34.006388 OH
Anesthesiology Physician 207L00000X 036.131960 IL Primary

Addresses

Primary practice location

21120 Washington Pkwy
Frankfort, IL 60423-3112

Mailing address

21120 Washington Pkwy
Frankfort, IL 60423-3112
Phone (815) 469-9750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230123000915 NY Practitioner - Anesthesiology 5395843106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Ohio University, College of Osteopathic Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Abbott Anesthesiologist Associates PCGroup PAC ID 5991784449, 18 clinicians

Practice addresses (Care Compare)

515 Abbott Rd
Suite 410
Buffalo, NY 14220-1700
Phone (716) 826-6628

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036.131960ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Abbott Anesthesiologist Associates PC CurrentSince Mar 4, 2024 Accepting new patients
Mercy Anesthesia Group, LLC Past Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients

Locations

515 Abbott Rd
Ste 410
Buffalo, NY 14220
Phone (716) 826-6628

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1215996582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21120 WASHINGTON PKWY",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233112",
            "telephone_number": "815-469-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21120 WASHINGTON PKWY",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233112",
            "telephone_number": "815-469-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTH",
        "first_name": "LANNY",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "OS7770",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "34.006388",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036.131960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

Verify at the official NPI Registry.