Individual provider Active NPI

Robert Charles Anderson, LDO

  • Optician
  • Pooler, GA
National Provider Identifier
1669380341
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
LDO001726 Issued in GA
Practice address
104 US Highway 80 W Unit a
Pooler, GA 31322-2504
Phone
(912) 330-1200
NPI assigned
Sep 1, 2026
Last updated
Sep 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X LDO001726 GA Primary

Addresses

Primary practice location

104 US Highway 80 W Unit a
Pooler, GA 31322-2504

Mailing address

104 US Highway 80 W Unit a
Pooler, GA 31322-2504
Phone (912) 330-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LDO001726GAMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Optical, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1788220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1669380341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 US HIGHWAY 80 W UNIT A",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222504",
            "telephone_number": "912-330-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 US HIGHWAY 80 W UNIT A",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222504",
            "telephone_number": "912-330-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-01",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "GA",
            "license": "LDO001726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.