Robert S. NA, LDO

Primary specialty

OpticianTaxonomy code 156FX1800X

License

001684 Issued in GA

Practice address

310 Town Center Ave
Suite A1
Suwanee, GA 30024-6856

Phone

(678) 468-7525

Fax

(678) 482-1668

NPI assigned

Feb 3, 2011

Last updated

Mar 13, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1296691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1205132552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 TOWN CENTER AVE",
            "address_2": "SUITE A1",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246856",
            "telephone_number": "678-468-7525",
            "fax_number": "678-482-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 TOWN CENTER AVE",
            "address_2": "SUITE A1",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246856",
            "telephone_number": "678-468-7525",
            "fax_number": "678-482-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NA",
        "first_name": "ROBERT",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-03",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "GA",
            "license": "001684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optician in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Optician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.