NPIMap

Organization Active NPI

Norton Children's Medical Group, LLC

Doing business as Norton Children's Surgery

  • Pediatric Surgery Physician
  • Louisville, KY
National Provider Identifier
1306487764
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
Legal business name
NORTON CHILDREN'S MEDICAL GROUP, LLC
Doing business as
Norton Children's Surgery
Practice address
4803 Olympia Park PLZ Ste 1100
Louisville, KY 40241-3068
Phone
(502) 272-5336
Fax
(502) 272-5339
NPI assigned
Oct 7, 2019
Last updated
Jan 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Shelley Gast
Title
Syst VP of MNGD Care & Payor Strat
Phone
(502) 272-5335

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X NU Primary
Speech-Language Pathologist 235Z00000X NU
Physician Assistant 363A00000X NU
Medical Physician Assistant 363AM0700X NU
Surgical Physician Assistant 363AS0400X NU
Nurse Practitioner 363L00000X NU

Addresses

Primary practice location

4803 Olympia Park PLZ Ste 1100
Louisville, KY 40241-3068

Mailing address

PO Box 776879
Chicago, IL 60677-6879
Phone (502) 272-5336

Other names 1

  • Norton Children's Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200102000758 KY Part B Supplier - Clinic/Group Practice 3779917596 Receives reassigned benefits from 1,011 practitioners
31 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 31

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 31

National Provider Directory

National Provider Directory
Tax ID family
Norton Childrens Medical Group LLC25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations

1000 Saint Joseph LN
London, KY 40741

411 E Chestnut St
#5
Louisville, KY 40202
Phone (502) 588-0390

411 E Chestnut St
Fl 4C
Louisville, KY 40202

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1306487764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-272-5336",
            "fax_number": "502-272-5339"
        },
        {
            "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": "502-272-5336",
            "fax_number": "502-272-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTON CHILDREN'S MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-07",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "GAST",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "SYST VP OF MNGD CARE & PAYOR STRAT",
        "authorized_official_telephone_number": "502-272-5335",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Norton Children's Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Norton Children's Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.