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JASON A. KING, PH.D., LLC
NPI 1700980224
Psychologist - Clinical in Smyrna, GA

Active since September 13, 2006
2400 LAKE PARK DR SE STE 110, SMYRNA, GA 30080(770) 933-4130(770) 933-4135 Get Directions Write a Review

NPPES record last updated: May 29, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 29, 2026, Aug 22, 2020 (2 updates tracked since 2020).

About Jason A. King, Ph.d., Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JASON A. KING, PH.D., LLC (NPI 1700980224) is a healthcare organization registered as a clinical in Smyrna, Georgia and active in the NPI registry since September 2006. The organization lists Jason Anthony King, President, as its authorized official.

NPPES Registry Identity

NPI1700980224
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameJASON A. KING, PH.D., LLC
Location Address2400 LAKE PARK DR SE STE 110Smyrna, GA 30080-8979
Mailing Address2400 Lake Park Dr Se Ste 110Smyrna, GA 30080-8979 · (770) 933-4130 · Fax (770) 933-4135
Phone(770) 933-4130
Fax(770) 933-4135
Organization SubpartNo
Authorized OfficialJason Anthony KingPresident · (770) 933-4130
Enumeration DateSeptember 13, 2006
Last NPPES UpdateMay 29, 20262 updates tracked since enumeration
NPPES CertifiedMay 29, 2026
✔ NPI 1700980224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in GA · PSY002888
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
2400 LAKE PARK DR SE STE 110, Smyrna, GA 30080
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jason A. King, Ph.d., Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Jason A. King, Ph.D., LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Sabrina Hickle, PH.D.
Clinical Psychologist
NPI 1205500535
2400 LAKE PARK DR SE STE 110
Smyrna, GA 30080
(770) 933-4130
✔ PECOS✔ Accepts MedicareSame address
Jason King, PH.D.
Clinical Psychologist
NPI 1215157169
2400 LAKE PARK DR SE STE 110
Smyrna, GA 30080
(770) 933-4130
✔ PECOS✔ Accepts MedicareSame address
Catherine Rogers, PH.D
Clinical Psychologist
NPI 1174707756
2400 LAKE PARK DR SE STE 110
Smyrna, GA 30080
(770) 933-4130
✔ PECOS✔ Accepts MedicareSame address
Miriam Shapiro, PHD
Psychologist Billing Independently
NPI 1861877292
2400 LAKE PARK DR SE STE 110
Smyrna, GA 30080
(770) 933-4130
Same address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jason A. King, Ph.D., LLC's NPI number?

The NPI number for Jason A. King, Ph.D., LLC is 1700980224. It was assigned to this organization in the NPPES registry on September 13, 2006.

Where is Jason A. King, Ph.D., LLC located?

Jason A. King, Ph.D., LLC is located at 2400 Lake Park Dr SE Ste 110, Smyrna, GA 30080. The listed phone number is (770) 933-4130.

What is Jason A. King, Ph.D., LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jason A. King, Ph.D., LLC enrolled in Medicare?

Yes. Jason A. King, Ph.D., LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jason A. King, Ph.D., LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Jason A. King, Ph.D., LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Psychologist (3) and Psychologist Billing Independently (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jason A. King, Ph.D., LLC was last updated on May 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.