Community Medical Associates, Inc.
Organization Active NPI Anesthesiology Physician · Louisville, KY
NPI 1194451179 · NPPES record last updated Aug 1, 2024
Key facts
- NPI
- 1194451179
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- COMMUNITY MEDICAL ASSOCIATES, INC.
- Practice address
- 4803 Olympia Park PLZ Ste 1100
Louisville, KY 40241-3068 - Phone
- (502) 559-9409
- NPI assigned
- Aug 1, 2022
- Organization subpart
- No
Authorized official
- Name
- Shelley Gast
- Title
- VP Managed Care
- Phone
- (502) 272-5335
Other NPIs on the same Medicare enrollment 18
Corporate family (same tax ID) 26
Practitioners 21
-
Cody Lind Hambleton, APRN-NA
-
Aaron E Medley, MD
-
Michael J. Phythian, CRNA
-
Christopher Byron White, CRNA
-
Ashley Boone, PA-C
-
Mary Elizabeth Dore, CRNA
-
Alan Hsieh, MD
-
Ralph L Luellen III, CRNA
-
Justin A Otis, DNP, APRN-CRNA
-
Bryan L Richardson, CRNA
-
Saniya Sami, M.D.
-
Gene Shilkrot, MD
-
Justin M Vermeulen, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040309000452 | IN | Part B Supplier - Clinic/Group Practice | 7012811284 |
Receives reassigned benefits from 460 practitioners 18 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Jeffersonville, IN; Madison, IN; New Albany, IN; Salem, IN; Scottsburg, IN; Sellersburg, IN; Versailles, IN; Vevay, IN… |
National Provider Directory
- Tax ID family
- Community Medical Assoc Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes | ||
| Internal Medicine Physician |
207R00000X | |||
| Nurse Practitioner |
363L00000X | |||
| Certified Registered Nurse Anesthetist |
367500000X |
Addresses
Primary practice location
4803 Olympia Park PLZ Ste 1100
Louisville, KY 40241-3068
Mailing address
PO Box 776351
Chicago, IL 60677-6351
Phone (502) 558-9490
Other names
- Norton Anesthesiology
NPI Registry JSON
{
"created_epoch": "1659312000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1722470400000",
"number": "1194451179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 776351",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606776351",
"telephone_number": "502-558-9490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4803 OLYMPIA PARK PLZ STE 1100",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402413068",
"telephone_number": "502-559-9409"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMMUNITY MEDICAL ASSOCIATES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2022-08-01",
"last_updated": "2024-08-01",
"certification_date": "2024-08-01",
"status": "A",
"authorized_official_last_name": "GAST",
"authorized_official_first_name": "SHELLEY",
"authorized_official_title_or_position": "VP MANAGED CARE",
"authorized_official_telephone_number": "502-272-5335"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Anesthetist, Certified Registered",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Norton Anesthesiology",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Norton Anesthesiology",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Louisville, KY
- Community Medical Associates, Inc.
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- Community Medical Associates, Inc.
- Community Medical Associates, Inc.
- Community Medical Associates, Inc.
- Community Medical Associates, Inc.
- Community Medical Associates, Inc.
- Community Medical Associates, Inc.
All providers in Louisville, KY · Anesthesiology Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.