Organization Active NPI

Lanny S Odin MD SC

  • Ophthalmology Physician
  • Taylorville, IL
National Provider Identifier
1972997286
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
LANNY S ODIN MD SC
Practice address
500 N Cheney St
Taylorville, IL 62568-1139
Phone
(217) 777-2020
Fax
(217) 777-2023
NPI assigned
Mar 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Authorized official

Name
Lanny Scott Odin, M. D.
Title
President
Phone
(217) 777-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X IL Primary

Addresses

Primary practice location

500 N Cheney St
Taylorville, IL 62568-1139

Mailing address

PO Box 110
Taylorville, IL 62568-0110
Phone (217) 777-2020

Other names 1

  • CENTRAL ILLINOIS RETINA INSTITUTE Doing business as

National Provider Directory

National Provider Directory

Locations

110 E Ryder St
Litchfield, IL 62056
Phone (217) 324-2762

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1972997286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625680110",
            "telephone_number": "217-777-2020",
            "fax_number": "217-777-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N CHENEY ST",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625681139",
            "telephone_number": "217-777-2020",
            "fax_number": "217-777-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANNY S ODIN MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-25",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "ODIN",
        "authorized_official_first_name": "LANNY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-777-2020",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTRAL ILLINOIS RETINA INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taylorville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.