# NORTON CHILDREN'S MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Norton Children's Acupunture
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588205199
- **Authorized official:** MS. SHELLEY GAST (SYST VP OF MNGD CARE & PAYOR STRAT)
- **Authorized official phone:** (502) 272-5335

## Contact information

- **Practice address:** 4803 OLYMPIA PARK PLZ STE 1100, LOUISVILLE, KY 40241-3068
- **Practice address phone:** (502) 272-5336
- **Practice address fax:** (502) 272-5339
- **Mailing address:** PO BOX 776879, CHICAGO, IL 60677-6879
- **Mailing address phone:** (502) 272-5336
- **Mailing address fax:** (502) 272-5339

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | NULL | Yes |
| 171100000X | Acupuncturist | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2084N0402X | Neurology with Special Qualifications in Child Neurology Physician | — | NULL | — |
| 2084N0402X | Neurology with Special Qualifications in Child Neurology Physician | — | — | — |
| 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 | — | — | — |

## Other

- **Enumeration date:** 10/04/2019
- **Last updated:** 09/22/2021