Douglas Klim, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW4727 Issued in FL

Practice address

4190 Belfort Rd Ste 140
Jacksonville, FL 32216-5871

Phone

(904) 296-1120

Fax

(904) 296-0229

NPI assigned

Dec 18, 2006

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: douglas.klim.1@19860.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carlos Torrellas MD, LLC

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1235941857
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1154484517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 BELFORT RD STE 140",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165871",
            "telephone_number": "904-296-1120",
            "fax_number": "904-296-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 BELFORT RD STE 140",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165871",
            "telephone_number": "904-296-1120",
            "fax_number": "904-296-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIM",
        "first_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW4727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Alyssa Klem, DO
• Rebekah F Klempin
• Claudia I Klenck, M.D.
• Dane E Klett, M.D.
• Sean H Klicker, PHARM D
• Jeremy Klimek
• Michelle Klindtworth, CCC-SLP
• Amanda Kling, APRN
• Rebecca Klingbeil, CRNA
• Bridgette D Klohe

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.