Leslie A Clark, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11009779 Issued in FL

Practice address

1730 Dunlawton Ave Ste 1
Port Orange, FL 32127-8986

Phone

(386) 320-3299

NPI assigned

Dec 9, 2020

Last updated

Oct 3, 2022By the provider in NPPES

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Sunshine Physicians Inc

  • Internal Medicine Physician
  • Port Orange, FL
  • NPI 1376998971
  Medicare reassignment NPD

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1700482163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 DUNLAWTON AVE STE 1",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321278986",
            "telephone_number": "386-320-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 DUNLAWTON AVE STE 1",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321278986",
            "telephone_number": "386-320-3299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 N Causeway Ste C",
            "address_purpose": "LOCATION",
            "city": "New Smyrna Beach",
            "state": "FL",
            "postal_code": "321695300",
            "country_code": "US",
            "telephone_number": "386-424-8440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LESLIE",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-09",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11009779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Antony Ciolfi, DC, HBPE,BSE
• City of Port Orange
• Tamara R Clancy, MD
• Diane Marie Clark, D.C.
• Lauren Clark
• Felicia Clarke
• Sarah Clarke
• Brittany Michele Claude
• Jeffery Kyle Clifton, DC
• Clinical Acumen LLC.

• Nurse Practitioner in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.