COMMUNITY MEDICAL ASSOCIATES, INC.

Provider Demographics

• NPI: 1437382074
• Name: COMMUNITY MEDICAL ASSOCIATES, INC.
• Entity Type: Organization
• Organization Name: COMMUNITY MEDICAL ASSOCIATES, INC.
• Authorized Official - Title/Position: VP MANAGED CARE
• Authorized Official - First Name: SHELLEY
• Authorized Official - Last Name: GAST
• Authorized Official - Phone: 502-588-9490
• Mailing Address - Street 1: PO BOX 776351
• Mailing Address - City: CHICAGO
• Mailing Address - State: IL
• Mailing Address - Zip Code: 60677-6351
• Mailing Address - Country: US
• Mailing Address - Phone: 502-588-9490
• Mailing Address - Fax: 502-272-5114
• Practice Address - Street 1: 4803 OLYMPIA PARK PLZ STE 1100
• Practice Address - City: LOUISVILLE
• Practice Address - State: KY
• Practice Address - Zip Code: 40241-3068
• Practice Address - Country: US
• Practice Address - Phone: 502-588-9490
• Practice Address - Fax: 502-272-5339
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2009-08-31
• Last Update Date: 2023-04-03

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207XS0117X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery	Orthopaedic Surgery of the Spine	Group - Single Specialty
No	103G00000X	Behavioral Health & Social Service Providers	Clinical Neuropsychologist		Group - Single Specialty
No	1041C0700X	Behavioral Health & Social Service Providers	Social Worker	Clinical	Group - Single Specialty
No	207Q00000X	Allopathic & Osteopathic Physicians	Family Medicine		Group - Single Specialty
No	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine		Group - Single Specialty
No	207RC0000X	Allopathic & Osteopathic Physicians	Internal Medicine	Cardiovascular Disease	Group - Single Specialty
No	207RC0001X	Allopathic & Osteopathic Physicians	Internal Medicine	Clinical Cardiac Electrophysiology	Group - Single Specialty
No	207RI0011X	Allopathic & Osteopathic Physicians	Internal Medicine	Interventional Cardiology	Group - Single Specialty
No	207V00000X	Allopathic & Osteopathic Physicians	Obstetrics & Gynecology		Group - Single Specialty
No	207VM0101X	Allopathic & Osteopathic Physicians	Obstetrics & Gynecology	Maternal & Fetal Medicine	Group - Single Specialty
No	2080A0000X	Allopathic & Osteopathic Physicians	Pediatrics	Adolescent Medicine	Group - Single Specialty
No	235Z00000X	Speech, Language and Hearing Service Providers	Speech-Language Pathologist		Group - Single Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Single Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Single Specialty
No	363LC0200X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Critical Care Medicine	Group - Single Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
IN	200856060	Medicaid
IN	201036210	Medicaid
IN	201062230	Medicaid
IN	200952320	Medicaid
IN	100382650	Medicaid
KY	78901329	Medicaid
IN	201070860	Medicaid
IN	201062900	Medicaid
KY	65928301	Medicaid
IN	201036210	Medicaid
IN	196290	Medicare PIN
KY	65928301	Medicaid
KY	3619	Medicare PIN
IN	100382650	Medicaid