Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Latasha Denise Gray, PA-C

Individual provider Physician Assistant · NPI 1740507730

Mrs. Latasha Denise Gray, PA-C is a Physician Assistant in Atlanta, Georgia. Qualified in 2009, 17 years ago. Practices with Wellstreet of Georgia PC, a 431-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
17
Licensed in
CO
In the registry since
2010
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

650 N Ave NE # S204
Atlanta, GA 30308-2705
Phone: (404) 504-6554
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1061 Harmon Avenue, Fort Stewart, GA 31314-5674 — (912) 435-6965

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1091538 (CO)

Record details

NPI number1740507730
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 29, 2010
Last updated in NPPESAugust 2, 2021
Certification dateAugust 2, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Wellstreet Of Georgia Pc — 431 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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