Laurie Anne Clark, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

95 Collier Rd NW Ste 6015
Atlanta, GA 30309-1750

Phone

(491) 351-5959

NPI assigned

Jan 6, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Laurie Anne Dielmann Former name

Medicare fee-for-service enrollment

Enrolled in GA, MD2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greater Baltimore Medical CenterGroup PAC ID 1759276975, 350 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Greater Baltimore Medical Center Hospital, Baltimore, MD, CCN 210044

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Greater Baltimore Medical Center, Inc

  • Obstetrics & Gynecology Physician
  • Baltimore, MD
  • NPI 1891855763
  Medicare reassignment Care Compare group
• Greater Baltimore Medical Center, Inc.

  • Sleep Medicine (Internal Medicine) Physician
  • Baltimore, MD
  • NPI 1538029731
  NPD
• Greater Baltimore Medical Center, Inc.

  • Surgery Physician
  • Baltimore, MD
  • NPI 1922036771
  NPD

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

• Greater Baltimore Medical Center, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1255372397
  Care Compare affiliation

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1023388014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 870",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421731",
            "telephone_number": "443-910-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 COLLIER RD NW STE 6015",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091750",
            "telephone_number": "491-351-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LAURIE",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "DIELMANN",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julia Clark, LMSW
• Kathleen Linton Clark, APRN-BC
• Kathy Clark, CAT
• Kimberly Anne Clark, RBT
• Kristiana Alivia Clark, NP-C
• Lyndsey Clark
• Mark A Clark, MD
• Melinda Clark, LPC
• Michael Dean Clark, M.D.
• Michael Jeffery Clark, M.D.

• Surgical Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.