COMMUNITY MEDICAL ASSOCIATES, INC.

Provider Demographics

• NPI: 1922288760
• 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: 502-272-5335
• 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: 502-272-5339
• 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: 502-272-5116
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-11-09
• Last Update Date: 2024-02-22

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207T00000X	Allopathic & Osteopathic Physicians	Neurological Surgery		Group - Single Specialty
No	103G00000X	Behavioral Health & Social Service Providers	Clinical Neuropsychologist		Group - Single Specialty
No	163WD0400X	Nursing Service Providers	Registered Nurse	Diabetes Educator	Group - Single Specialty
No	204F00000X	Allopathic & Osteopathic Physicians	Transplant Surgery		Group - Single Specialty
No	207RB0002X	Allopathic & Osteopathic Physicians	Internal Medicine	Obesity Medicine	Group - Single Specialty
No	207X00000X	Allopathic & Osteopathic Physicians	Orthopaedic Surgery		Group - Single Specialty
No	208100000X	Allopathic & Osteopathic Physicians	Physical Medicine & Rehabilitation		Group - Single Specialty
No	2084V0102X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Vascular Neurology	Group - Single Specialty
No	208600000X	Allopathic & Osteopathic Physicians	Surgery		Group - Single Specialty
No	246ZC0007X	Technologists, Technicians & Other Technical Service Providers	Specialist/Technologist, Other	Surgical Assistant	Group - Single Specialty
No	363AS0400X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant	Surgical	Group - Single Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Single Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
KY	65928301	Medicaid
IN	100382650	Medicaid
IN	201062230	Medicaid
IN	200856060	Medicaid
IN	201036210	Medicaid
IN	201070860	Medicaid
IN	200952320	Medicaid
IN	201062900	Medicaid
KY	78901329	Medicaid
KY	78901329	Medicaid
IN	200856060	Medicaid
KY	9999	Other	DBA NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY