Individual provider Active NPI

Lauren Ashleigh Locklear Clark, PA

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1245776160
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06943 Issued in NC
Practice address
1521 Owen Park LN
Fayetteville, NC 28304-3454
Phone
(910) 223-7420
Fax
(910) 223-7452
NPI assigned
Jan 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-06943 NC Primary

Addresses

Primary practice location

1521 Owen Park LN
Fayetteville, NC 28304-3454

Mailing address

PO Box 296
Bryson City, NC 28713-0296
Phone (910) 410-0010

Other practice location 1

4901 Dawn Dr Ste 3200
Lumberton, NC 28360-8288
Phone (910) 735-8040

Other identifiers 2

IdentifierTypeStateIssuer
NCW457AOtherNCMEDICARE PTAN
1245776160MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address llocklearclark1514065@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170328001715 NC Practitioner - Physician Assistant 0547545865 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-06943NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC CurrentSince Mar 2, 2026 Accepting new patients
Unc Physicians Network LLC CurrentSince Mar 2, 2026 Accepting new patients
A Brighter Future Medical PastSince Sep 15, 2024 Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

4901 Dawn Dr
Ste 3200
Lumberton, NC 28360
Phone (910) 735-8040

Interoperability endpoints

  • Direct secure messaging: llocklearclark1514065@direct.unc.nchie.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1245776160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 296",
            "city": "BRYSON CITY",
            "state": "NC",
            "postal_code": "287130296",
            "telephone_number": "910-410-0010",
            "fax_number": "828-538-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 OWEN PARK LN",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043454",
            "telephone_number": "910-223-7420",
            "fax_number": "910-223-7452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4901 Dawn Dr Ste 3200",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "NC",
            "postal_code": "283608288",
            "country_code": "US",
            "telephone_number": "910-735-8040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOCKLEAR CLARK",
        "first_name": "LAUREN",
        "middle_name": "ASHLEIGH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NCW457A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245776160",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "llocklearclark1514065@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4901 Dawn Dr Ste 3200",
            "city": "Lumberton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283608288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.