Organization
COMMUNITY MEDICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. 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) 272-5165
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
01/25/2018
Last updated
09/21/2021
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