Jason King, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY002888 Issued in GA

Practice address

2400 Lake Park Dr SE Ste 110
Smyrna, GA 30080-8979

Phone

(770) 933-4130

Fax

(770) 933-4130

NPI assigned

Apr 25, 2007

Last updated

May 29, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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 GA

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 Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jason a King PHD LLCGroup PAC ID 1153338850, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Jason a. King, PH.D., LLC

  • Clinical Psychologist
  • Smyrna, GA
  • NPI 1700980224

  Clinical Neuropsychologist

  Medicare reassignment Care Compare group NPD Authorized official
• Neuropsychology Associates of Georgia LLC

  • Clinical Neuropsychologist
  • Atlanta, GA
  • NPI 1720614746
  NPD Authorized official

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1215157169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 LAKE PARK DR SE STE 110",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808979",
            "telephone_number": "770-933-4130",
            "fax_number": "770-933-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 LAKE PARK DR SE STE 110",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300808979",
            "telephone_number": "770-933-4130",
            "fax_number": "770-933-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ji Young Min Kim
• Kimberlynn R. Richards, MD, PC
• Guatemala Kimble, FNP-C
• Jennifer Kimmerle, LMFT
• Annie V King, LHAD
• Kingdom Counseling and Consultation LLC
• Jacqueline Kinnon
• Laura Waligura Kirk
• Sean Taylor Kirkland, LMFT
• Arlene Kish, LPC

• Clinical Psychologist in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; 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.