Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Makala Raven Gore, PA

Individual provider Physician Assistant · NPI 1861289571

Makala Raven Gore, PA is a Physician Assistant in Newnan, Georgia. Qualified in 2025, 1 year ago. Practices with Piedmont Providers LLC, a 518-clinician group and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2025
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

775 Poplar Rd Ste 160A
Newnan, GA 30265-8302
Phone: (770) 400-4630
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1861289571
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 24, 2025
Last updated in NPPESSeptember 16, 2025
Certification dateSeptember 16, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Piedmont Providers Llc — 518 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Newnan