Individual provider Active NPI

Lanny Coker, CRNA

  • Certified Registered Nurse Anesthetist
  • Memphis, TN
National Provider Identifier
1811954514
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9179 Issued in TN
Practice address
877 Jefferson Ave
Memphis, TN 38103-2807
Phone
(901) 545-7100
Fax
(901) 448-5540
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 9179 TN Primary

Addresses

Primary practice location

877 Jefferson Ave
Memphis, TN 38103-2807

Mailing address

877 Jefferson Ave
Attn: Provider Enrollment
Memphis, TN 38103-2807

Other identifiers 1

IdentifierTypeStateIssuer
3608393MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100617000510 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931239985 Reassigns benefits to 3 organizations
I20210709000354 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931239985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midsouth Speciality Anesthesia Services LLCGroup PAC ID 6103293667, 29 clinicians

Practice addresses (Care Compare)

1750 Madison Ave
Suite 300
Memphis, TN 38104-6428
Phone (901) 390-2930

312 S Rhodes St
West Memphis, AR 72301-4215
Phone (901) 390-2930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9179TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Anesthesia Group, PA CurrentSince Dec 18, 2024 Accepting new patients
Midsouth Speciality Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2022 Accepting new patients

Locations

312 S Rhodes St
West Memphis, AR 72301
Phone (870) 733-1240

1355 W Brierbrook Rd
Germantown, TN 38138
Phone (901) 755-8300

1363 S Germantown Rd
Memphis, TN 38138
Phone (901) 516-6000

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1750 Madison Ave
Ste 300
Memphis, TN 38104
Phone (901) 725-7025

1417 Monroe Ave
Memphis, TN 38104
Phone (901) 272-7200

3301 S 14th St
Ste 16180
Abilene, TX 79605

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1811954514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "address_2": "ATTN: PROVIDER ENROLLMENT",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-545-7100",
            "fax_number": "901-448-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COKER",
        "first_name": "LANNY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "9179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3608393",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.