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Organization
NORTON CHILDREN'S MEDICAL GROUP, LLC
Active
Organization
NORTON CHILDREN'S MEDICAL GROUP, LLC
Active
Other names
Norton Children's Emergency Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY GAST (SYST VP MNGD CARE & PAYOR STRAT)
(502) 272-5335
Entity
Organization
Contact information
Practice address
4803 OLYMPIA PARK PLZ STE 1100, LOUISVILLE, KY 40241-3068
(502) 272-5134
(502) 272-5339
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 272-5134
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
—
NULL
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
NULL
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
NULL
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
12/13/2019
Last updated
09/22/2021
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