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) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XX0801X
Orthopaedic Trauma Physician
—
—
2084A2900X
Neurocritical Care Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
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
05/10/2006
Last updated
11/03/2023
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