NPIMap

Individual provider Active NPI

Derek Arthur Klemm, D.O., PHARM.D.

  • Addiction Medicine (Family Medicine) Physician
  • Demorest, GA
National Provider Identifier
1225300494
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
080289 Issued in GA
Practice address
396 Historic Highway 441 N
Demorest, GA 30535
Phone
(706) 754-4348
Fax
(706) 754-0731
NPI assigned
Feb 3, 2012
Last updated
Mar 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pharmacist 183500000X PS47555 FL
Family Medicine Physician 207Q00000X 080289 GA
Family Medicine Physician 207Q00000X OS14186 FL
Addiction Medicine (Family Medicine) Physician 207QA0401X 080289 GA Primary
General Practice Physician 208D00000X UO4670 FL

Addresses

Primary practice location

396 Historic Highway 441 N
Demorest, GA 30535

Mailing address

PO Box 459
Colbert, GA 30628-0459
Phone (706) 788-3234

Other identifiers 1

IdentifierTypeStateIssuer
080289OtherGAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181119002180 GA Practitioner - Family Practice 8729332242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medlink Georgia IncGroup PAC ID 3274442850, 93 clinicians

Practice addresses (Care Compare)

396 Historic Hwy 441 N
Demorest, GA 30535-4522
Phone (706) 872-2972

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS47555FLMDPharmacist
OS14186FLMDFamily Medicine Physician
080289GAMDAddiction Medicine (Family Medicine) Physician
UO4670FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medlink Georgia Inc CurrentSince Jul 2, 2018 Accepting new patients
Medlink Georgia, Inc CurrentSince Jul 2, 2018 Accepting new patients
Medlink Georgia Inc Past Accepting new patients

Locations

896 Highway 441 S
Clayton, GA 30525
Phone (706) 782-5991

17 White St
Cleveland, GA 30528
Phone (706) 865-4001

25 Old Blairsville Rd
Cleveland, GA 30528
Phone (706) 969-7510

2648 Highway 129 N
Cleveland, GA 30528
Phone (706) 725-4000

11 Charlie Morris Rd
Bldg 2
Colbert, GA 30628
Phone (706) 738-3234

112 Banks Rd
Ste 1
Commerce, GA 30529
Phone (706) 677-4568

396 441 Historic Hwy N
Demorest, GA 30535
Phone (706) 754-4348

56 Firewater Ln
Suches, GA 30572
Phone (706) 747-1036

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: derek.klemm.1@9864.direct.athenahealth.com
  • Direct secure messaging: derek.klemm@mgi.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1225300494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "COLBERT",
            "state": "GA",
            "postal_code": "306280459",
            "telephone_number": "706-788-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 HISTORIC HIGHWAY 441 N",
            "city": "DEMOREST",
            "state": "GA",
            "postal_code": "30535",
            "telephone_number": "706-754-4348",
            "fax_number": "706-754-0731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEMM",
        "first_name": "DEREK",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "D.O., PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-03",
        "last_updated": "2023-03-10",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS47555",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "080289",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS14186",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "GA",
            "license": "080289",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "UO4670",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "080289",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Demorest, GA

Sources for this page

Verify at the official NPI Registry.