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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 Genetics Center
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) 272-5336
(502) 272-5339
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 272-5336
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
133VN1006X
Metabolic Nutrition Registered Dietitian
—
NULL
133VN1006X
Metabolic Nutrition Registered Dietitian
—
—
170300000X
Genetic Counselor (M.S.)
—
NULL
170300000X
Genetic Counselor (M.S.)
—
—
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
—
NULL
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
—
—
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
09/29/2020
Last updated
01/10/2022
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