Robin G Berding, O.D
Individual provider Active NPI Optometrist · Pooler, GA
NPI 1710047329 · NPPES record last updated Dec 27, 2022
Key facts
- NPI
- 1710047329
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OPT001177 (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
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160318000177 | GA | Practitioner - Optometry | 5294838876 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001177 | GA | MD | Marriage & Family Therapist |
| OPC2705 | FL | MD | Optometrist |
| OPT001177 | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myeyedr Optometry of Georgia, LLC | Optometrist | Current |
Accepting new patients |
| Ga Doctors of Optometry LLC | Optometrist | Current |
Accepting new patients |
| Ga Doctors of Optometry LLC | Optometrist | Current |
Accepting new patients |
| Myeyedr Optometry of Georgia, LLC | Optometrist | Current |
Accepting new patients |
| Low Country Eye Associates, PC | Optometrist | Current |
Accepting new patients |
| Rose Eye Care LLC | Optometrist | Current |
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
105 Grand Central Blvd
Ste 110
Pooler, GA 31322
Phone (912) 450-9200
1000 Towne Center Blvd
Ste 502
Pooler, GA 31322
Phone (912) 748-1272
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 001177 | GA | |
| Optometrist | 152W00000X | OPC2705 | FL | |
| Optometrist | 152W00000X | OPT001177 | GA | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52295473 | Other | GA | BLUE CROSS BLUE SHIELD GA |
| 00477815A | Medicaid | GA |
Other providers in Pooler, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.