Organization
COMMUNITY MEDICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY GAST (VP MANAGED CARE)
(502) 272-5335
Entity
Organization
Contact information
Practice address
4803 OLYMPIA PARK PLZ STE 1100, LOUISVILLE, KY 40241-3068
(502) 588-9490
(502) 272-5116
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
—
—
163WD0400X
Diabetes Educator Registered Nurse
—
—
204F00000X
Transplant Surgery Physician
—
—
207RB0002X
Obesity Medicine (Internal Medicine) Physician
—
—
207T00000X
Neurological Surgery Physician
Primary
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2084V0102X
Vascular Neurology Physician
—
—
208600000X
Surgery Physician
—
—
246ZC0007X
Surgical Assistant
—
—
363AS0400X
Surgical 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
11/09/2007
Last updated
02/22/2024
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