Anthony David Anderson Jr., LDO

Primary specialty

OpticianTaxonomy code 156FX1800X

License

1101003190 Issued in VA

Practice address

315 Furr St
South Hill, VA 23970-9500

Phone

(434) 447-2777

Fax

(434) 447-2908

NPI assigned

May 24, 2023

Last updated

May 24, 2023By 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

Other names 1

• Mr. Anthony David Anderson Jr. Professional name

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": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1255023685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 FURR ST",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239709500",
            "telephone_number": "434-447-2777",
            "fax_number": "434-447-2908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 FURR ST",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239709500",
            "telephone_number": "434-447-2777",
            "fax_number": "434-447-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ANTHONY",
        "middle_name": "DAVID",
        "name_suffix": "Jr.",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "VA",
            "license": "1101003190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTHONY",
            "last_name": "ANDERSON",
            "middle_name": "DAVID",
            "prefix": "MR.",
            "suffix": "JR.",
            "credential": "LDO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Optician in South Hill, VA
• Providers in South Hill, VA by specialty
• Optician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.