Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Ledontrae Gooden, PA-C

Individual provider Medical Physician Assistant · NPI 1528607272

Mr. Ledontrae Gooden, PA-C is a Physician Assistant in Fort Moore, Georgia. Qualified in 2022, 4 years ago. Practices with Emory Medical Care Foundation Inc, a 996-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

6600 Van Aalst Blvd
Fort Moore, GA 31905-2102
Phone: (916) 385-1006
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2400 Nw 24th St, Lincoln, NE 68524-1892 — (478) 542-0311

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X
Driver Taxonomy 172A00000X

Record details

NPI number1528607272
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedDecember 28, 2019
Last updated in NPPESJanuary 22, 2024
Certification dateJanuary 22, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Emory Medical Care Foundation Inc — 996 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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