Organization
NORTON CHILDRENS MEDICAL GROUP, LLC
Active
Other names
Norton Children's Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHELLEY GAST (SYST VP OF 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
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
208000000X
Pediatrics Physician
Primary
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
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
08/26/2019
Last updated
12/10/2021
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