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Organization

COMMUNITY MEDICAL ASSOCIATES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHELLEY GAST (VP MANAGED CARE)
(502) 588-9490
Entity
Organization

Contact information

Practice address
4803 OLYMPIA PARK PLZ STE 1100, LOUISVILLE, KY 40241-3068
(502) 588-9490
(502) 272-5339
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5114

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
1041C0700X
Clinical Social Worker
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
207RC0000X
Cardiovascular Disease Physician
207RC0001X
Clinical Cardiac Electrophysiology Physician
207RI0011X
Interventional Cardiology Physician
207V00000X
Obstetrics & Gynecology Physician
207VM0101X
Maternal & Fetal Medicine Physician
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
2080A0000X
Pediatric Adolescent Medicine Physician
235Z00000X
Speech-Language Pathologist
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner
363LC0200X
Critical Care Medicine Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100382650
IN
05
200856060
IN
05
200952320
IN
05
201036210
IN
05
201062230
IN
05
201062900
IN
05
201070860
IN
05
65928301
KY
05
78901329
KY
Enumeration date
08/31/2009
Last updated
04/03/2023
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