Individual provider Active NPI

John Klimko Jr.

  • Marriage & Family Therapist
  • Valdosta, GA
National Provider Identifier
1447292958
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
000839 Issued in GA
Practice address
3790 Old US Highway 41 N Ste a
Valdosta, GA 31602-6865
Phone
(229) 262-1000
Fax
(229) 262-1085
NPI assigned
Jun 11, 2006
Last updated
Aug 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 000839 GA Primary

Addresses

Primary practice location

3790 Old US Highway 41 N Ste a
Valdosta, GA 31602-6865

Mailing address

2208 Brighton PL
Valdosta, GA 31602-2707
Phone (229) 563-1066

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231227001857 GA Practitioner - Marriage and Family Therapist 4880044254 Practice locations: Valdosta, GA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3790 Old US 41
Suite a
Valdosta, GA 31602-6865
Phone (229) 262-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000839GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Livingstone a. Rasalam, M.D. P.C. PastSince Jun 15, 2014 Accepting new patients

Organizations & group practices 1

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1447292958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 BRIGHTON PL",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022707",
            "telephone_number": "229-563-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3790 OLD US HIGHWAY 41 N STE A",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026865",
            "telephone_number": "229-262-1000",
            "fax_number": "229-262-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIMKO",
        "first_name": "JOHN",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "000839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.