Leila Clark, NP
Individual provider Active NPI Family Nurse Practitioner · La Fayette, GA
NPI 1740728690 · NPPES record last updated Sep 25, 2025
Key facts
- NPI
- 1740728690
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 60018 (GA)
- Practice address
- 106 Pearl Dr Ste 106
La Fayette, GA 30728-7510 - Phone
- (706) 670-1001
- Fax
- (706) 935-3900
- NPI assigned
- Feb 10, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
- Group practices
- National Family Medical Associates of Georgia, LLC
Select Rehabilitation, LLC
Practice addresses (Care Compare)
106 Pearl Dr
Suite 106
La Fayette, GA 30728-7510
Phone (706) 670-1050
2600 Compass Rd
Glenview, IL 60026-8001
Hospital & facility affiliations
- Memorial Healthcare System, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170324002043 | GA | Practitioner - Nurse Practitioner | 7012292543 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60018 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clark Health Services LLC | Current |
Accepting new patients | |
| Weaver Health Services, LLC | Family | Current |
Accepting new patients |
| National Family Medical Associates of Georgia, LLC | Current |
Accepting new patients | |
| National Family Medical Associates, LLC | Current |
Accepting new patients |
Locations
601 S Harbour Island Blvd
Ste 200
Tampa, FL 33602
Phone (727) 322-3439
3500 Lenox Rd NE
Ste 1500
Atlanta, GA 30326
Phone (404) 720-8220
3257 Chattanooga Valley Rd
Flintstone, GA 30725
Phone (706) 841-7700
5610 Wendy Bagwell Pkwy
Hiram, GA 30141
Phone (770) 943-7808
5610 Wendy Bagwell Pkwy
Ste 103
Hiram, GA 30141
Phone (770) 943-7808
106 Pearl Dr
Ste 106
La Fayette, GA 30728
Phone (706) 620-0200
7566 Nashville St
Ringgold, GA 30736
Phone (706) 935-3600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 60018 | GA | Yes |
Addresses
Primary practice location
106 Pearl Dr Ste 106
La Fayette, GA 30728-7510
Mailing address
121 Justin Dr
La Fayette, GA 30728-6974
Phone (423) 653-6404
Other providers in La Fayette, GA
- Kim Cameron
- Careatc
- Sarah Carson
- Abdul Chowdhury
- Clark Health Services LLC
- Consistent Care Family Practice
- Countryside Hospice Care Inc
- Gwendolyn Abe De Leon
- Amanda Francis Deal
- Jimmie Denson
All providers in La Fayette, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.