Individual provider Active NPI

Devan Whittington Lenhart, DO

  • Surgery Physician
  • Olympia Fields, IL
National Provider Identifier
1275038176
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
336019 Issued in LA
Practice address
20201 Crawford Ave
Olympia Fields, IL 60461-1010
Phone
(708) 747-4000
NPI assigned
Mar 24, 2018
Last updated
Jan 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 336019 LA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

20201 Crawford Ave
Olympia Fields, IL 60461-1010

Mailing address

27 Colonial GRN
Loudonville, NY 12211-1703
Phone (518) 810-2769

Other practice location 1

6400 Perkins Rd
Baton Rouge, LA 70808-4124
Phone (225) 330-0497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20241221000019 GA Practitioner - General Surgery 2264789270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SGMC Physician Network IncGroup PAC ID 4082036843, 128 clinicians

Practice addresses (Care Compare)

2409 N Patterson St
Suite 200
Valdosta, GA 31602-2512
Phone (229) 333-1711

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
336019LAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SGMC Affiliated Services LLC Current Accepting new patients
SGMC Physician Network Inc Surgery CurrentSince Aug 1, 2024 Accepting new patients
South Georgia Medical Center Inc Student in an Organized Health Care Education/Training Program Past Accepting new patients

Locations

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

4280 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 433-7350

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": "1521849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1275038176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 COLONIAL GRN",
            "city": "LOUDONVILLE",
            "state": "NY",
            "postal_code": "122111703",
            "telephone_number": "518-810-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20201 CRAWFORD AVE",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611010",
            "telephone_number": "708-747-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6400 Perkins Rd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084124",
            "country_code": "US",
            "telephone_number": "225-330-0497",
            "fax_number": "225-330-0498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LENHART",
        "first_name": "DEVAN",
        "middle_name": "WHITTINGTON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-24",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "336019",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

Verify at the official NPI Registry.