Organization
NORTON CHILDREN'S MEDICAL GROUP, LLC
Active
Organization
NORTON CHILDREN'S MEDICAL GROUP, LLC
Active
Other names
Norton Children's Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
MS. 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
103G00000X
Clinical Neuropsychologist
—
—
1041C0700X
Clinical Social Worker
—
—
207T00000X
Neurological Surgery Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
225100000X
Physical Therapist
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
10/04/2019
Last updated
09/22/2021
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