Makala Raven Gore, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

775 Poplar Rd Ste 160a
Newnan, GA 30265-8302

Phone

(770) 400-4630

NPI assigned

Apr 24, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Piedmont Providers LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1548273592
  Medicare reassignment Care Compare group

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

• Piedmont Newnan Hospital, Inc.

  • General Acute Care Hospital
  • Newnan, GA
  • NPI 1134133002
  Care Compare affiliation

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

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1861289571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 POPLAR RD STE 160A",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658302",
            "telephone_number": "770-400-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 POPLAR RD STE 160A",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658302",
            "telephone_number": "770-400-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "MAKALA",
        "middle_name": "RAVEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Elizabeth Goldstein, DNP, APRN, FNP-BC
• Sara Ashley Golladay
• Matthew Dale Goode, D.C.
• Shar Alycia Goolsby, LPC
• Anabel Harley Gordon Fortier
• Kimberly Goston, APC
• Vanessa N. Goyes Ruiz, M.D.
• Embree Danielle Grable
• Grace Harbour Inc. Behavioral Health
• Grace Harbour, Inc.

• Physician Assistant in Newnan, GA
• Providers in Newnan, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.