NPI age
6 years
Enumerated 2019-12-28
● Active
Type 1 · Individual
MR. Ledontrae Gooden, PA-C
Gooden is 1 of 9 physician assistant providers in Fort Moore and 1 of 1333 in Georgia.
Primary specialty
Physician Assistant
Plus 1 subspecialty
Licensed in
—
0 states
Status
Active
No deactivations on record
Last NPPES update
2024-01-22
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 1333 active physician assistant providers in Georgia.
NPI age
6 years
↓ 9 yr below median (15 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
1
In the 21% of peers with subspecialties
NPI lifetime · 2019 → 2026
2019-12Enumerated in NPPES
2019
2026
Where they practice
Practice location
6600 Van Aalst Blvd
Fort Moore, GA 319052102
Mailing address
6600 Van Aalst Blvd Bldg 9250
Fort Moore, GA 319052102
Additional practice locations
1 secondary location on file with NPPES.
Location 2
2400 Nw 24th St
Lincoln, NE 685241892
Specialties
-
Physician Assistant PrimaryDefinition to come...
-
DriverA person employed to operate a motor vehicle as a carrier of persons or property.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | NONE | NONE |
Practice context
Part of a multi-provider practice. 115 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.