Individual provider Active NPI

Leslie Nicole Clemons, NP

  • Primary Care Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1942843149
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
11004147 Issued in FL
Practice address
2550 Simpson Rd
Kissimmee, FL 34744-4637
Phone
(407) 348-0990
Fax
(407) 944-9041
NPI assigned
Oct 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 11004147 FL Primary

Addresses

Primary practice location

2550 Simpson Rd
Kissimmee, FL 34744-4637

Mailing address

23 E Byrd Rd
Hartselle, AL 35640-8129
Phone (256) 751-0741

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
I20191227000117 FL Practitioner - Nurse Practitioner 5597199539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

52 W Underwood St
Orlando, FL 32806-1110
Phone (407) 841-5111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11004147FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Physicians Network Inc CurrentSince Apr 20, 2021 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Dec 22, 2020 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Dec 22, 2020 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

52 Underwood St
Orlando, FL 32806
Phone (321) 841-3581

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

1600 Budinger Ave
Ste D
Saint Cloud, FL 34769
Phone (407) 826-3006

Interoperability endpoints

  • Direct secure messaging: lclemons28094@orlandohealth.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1942843149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 E BYRD RD",
            "city": "HARTSELLE",
            "state": "AL",
            "postal_code": "356408129",
            "telephone_number": "256-751-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 SIMPSON RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444637",
            "telephone_number": "407-348-0990",
            "fax_number": "407-944-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMONS",
        "first_name": "LESLIE",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11004147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.