Individual provider Active NPI

Robin G Berding, O.D

  • Optometrist
  • Pooler, GA
National Provider Identifier
1710047329
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001177 Issued in GA
Practice address
105 Grand Central Blvd Ste 110
Pooler, GA 31322-4148
Phone
(912) 450-9200
Fax
(912) 450-9201
NPI assigned
Dec 12, 2006
Last updated
Dec 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 001177 GA
Optometrist 152W00000X OPC2705 FL
Optometrist 152W00000X OPT001177 GA Primary

Addresses

Primary practice location

105 Grand Central Blvd Ste 110
Pooler, GA 31322-4148

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160318000177 GA Practitioner - Optometry 5294838876 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001177GAMDMarriage & Family Therapist
OPC2705FLMDOptometrist
OPT001177GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Jan 12, 2024 Accepting new patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Jan 12, 2024 Accepting new patients
Low Country Eye Associates, PC Optometrist CurrentSince Jul 31, 2023 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jan 1, 2023 Accepting new patients
Rose Eye Care LLC Optometrist CurrentSince Sep 25, 2015 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jan 1, 2023 Accepting new patients
Southcoast Medical Group, LLC Past Accepting new patients
Oneopto Ga 1 PLLC Optometrist Past Accepting new patients

Locations

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

50 Main Street Market Pl SE
Ste 100
Cartersville, GA 30121
Phone (770) 382-6379

1000 Towne Center Blvd
Ste 502
Pooler, GA 31322
Phone (912) 748-1272

105 Grand Central Blvd
Ste 110
Pooler, GA 31322
Phone (912) 450-9200

1000 Gandy Dancer
Richmond Hill, GA 31324
Phone (912) 712-0132

14815 US Highway 19 S
Ste 1000
Thomasville, GA 31792
Phone (229) 221-5668

15196 US Highway 19 S
Thomasville, GA 31757
Phone (229) 228-4770

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 8

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1710047329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 GRAND CENTRAL BLVD STE 110",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224148",
            "telephone_number": "912-450-9200",
            "fax_number": "912-450-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERDING",
        "first_name": "ROBIN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "001177",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2705",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

Verify at the official NPI Registry.