Individual provider Active NPI

Laura Clark Least, PA-C

  • Physician Assistant
  • Tallahassee, FL
National Provider Identifier
1619451648
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111542 Issued in FL
Practice address
2457 Care Dr Ste D100
Tallahassee, FL 32308-3500
Phone
(850) 841-1166
Fax
(850) 942-5466
NPI assigned
Sep 15, 2018
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9111542 FL Primary
Medical Physician Assistant 363AM0700X PA9111542 FL

Addresses

Primary practice location

2457 Care Dr Ste D100
Tallahassee, FL 32308-3500

Mailing address

1705 Mahan Dr
Tallahassee, FL 32308-5201
Phone (850) 877-7164

Other practice location 1

1705 Mahan Dr
Tallahassee, FL 32308-5201
Phone (850) 877-7164

Other names 1

  • Laura Clark Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190130000875 FL Practitioner - Physician Assistant 1254678188 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1411 N Flagler Dr
Suite 8000
West Palm Beach, FL 33401-3413
Phone (561) 650-6231

2457 Care Dr
Suite D100
Tallahassee, FL 32308-3500
Phone (850) 841-1166

8825 Perimeter Park Blvd
Suite 102
Jacksonville, FL 32216-1127
Phone (904) 399-4004

Merit-based Incentive Payment System (MIPS)

Final score
50.88 of 100Reported as group
Quality
48.24
Promoting interoperability
0
Improvement activities
30
Cost
83.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9111542FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tenet Florida Physician Services LLC CurrentSince Aug 1, 2024 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Patients First Raymond Diehl Medical Center PA Past Accepting new patients
Gi Associates of Big Bend LLC Past Accepting new patients

Locations

8825 Perimeter Park Blvd
Ste 102
Jacksonville, FL 32216
Phone (904) 399-4004

2457 Care Dr
Ste D100
Tallahassee, FL 32308
Phone (850) 591-2979

1411 N Flagler Dr
Ste 8000
West Palm Beach, FL 33401
Phone (561) 650-6231

Organizations & group practices 5

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": "1536969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1619451648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 MAHAN DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085201",
            "telephone_number": "850-877-7164",
            "fax_number": "850-656-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2457 CARE DR STE D100",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323083500",
            "telephone_number": "850-841-1166",
            "fax_number": "850-942-5466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1705 Mahan Dr",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323085201",
            "country_code": "US",
            "telephone_number": "850-877-7164",
            "fax_number": "850-656-1391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEAST",
        "first_name": "LAURA",
        "middle_name": "CLARK",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-15",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111542",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9111542",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "CLARK",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.