Individual provider Active NPI

Kailin April Clanton, PA

  • Physician Assistant
  • MC Lean, VA
National Provider Identifier
1942979661
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110011264 Issued in VA
Practice address
1775 Tysons Blvd Ste 300
MC Lean, VA 22102-4285
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Sep 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 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 PA9114969 FL
Physician Assistant 363A00000X 0110011264 VA Primary

Addresses

Primary practice location

1775 Tysons Blvd Ste 300
MC Lean, VA 22102-4285

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

3501 Health Center Blvd
Estero, FL 34135-8127
Phone (239) 949-1050

Other identifiers 1

IdentifierTypeStateIssuer
115214100MedicaidFL

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
I20220128000853 FL Practitioner - Physician Assistant 7911399787 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardiac Arrhythmia Institute PAGroup PAC ID 5799836177, 4 clinicians
Thse - Marco Urgent Care LLCGroup PAC ID 8921131475, 19 clinicians

Practice addresses (Care Compare)

1540 S Tamiami TRL
Suite 305
Sarasota, FL 34239-2921
Phone (800) 771-7164

40 S Heathwood Dr
Marco Island, FL 34145-5026
Phone (239) 394-8234

5659 Naples Blvd
Naples, FL 34109-2023
Phone (941) 260-3111

6101 Pine Ridge Rd
Naples, FL 34119-3900
Phone (941) 766-4122

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9114969FLMDPhysician Assistant
0110011264VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Aug 29, 2022 Accepting new patients
Lee Memorial Health System Current Accepting new patients
Lee Memorial Health System CurrentSince Aug 29, 2022 Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

930 S Main St
Labelle, FL 33935
Phone (239) 343-3831

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 10

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": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1942979661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 TYSONS BLVD STE 300",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024285",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 Health Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Estero",
            "state": "FL",
            "postal_code": "341358127",
            "country_code": "US",
            "telephone_number": "239-949-1050",
            "fax_number": "239-949-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLANTON",
        "first_name": "KAILIN",
        "middle_name": "APRIL",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114969",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110011264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115214100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

Verify at the official NPI Registry.