NPIMap

Organization Active NPI

Community Medical Associates, Inc.

  • Multi-Specialty Clinic/Center
  • Louisville, KY
National Provider Identifier
1306983762
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
COMMUNITY MEDICAL ASSOCIATES, INC.
Practice address
4803 Olympia Park PLZ Ste 1100
Louisville, KY 40241-3068
Phone
(502) 588-9490
Fax
(502) 272-5116
NPI assigned
Feb 1, 2007
Last updated
Apr 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Authorized official

Name
Shelley Gast
Title
VP Managed Care
Phone
(502) 588-9490

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Multi-Specialty Clinic/Center 261QM1300X Primary
Urgent Care Clinic/Center 261QU0200X
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X
Surgical Physician Assistant 363AS0400X
Nurse Practitioner 363L00000X
Acute Care Nurse Practitioner 363LA2100X
Adult Health Nurse Practitioner 363LA2200X
Family Nurse Practitioner 363LF0000X
Pediatric Nurse Practitioner 363LP0200X
Clinical Neuropsychologist 103G00000X
Clinical Psychologist 103TC0700X

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) 588-9490

Other identifiers 3

IdentifierTypeStateIssuer
1003882650MedicaidIN
65946279MedicaidKY
65945693MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031120000656 KY Part B Supplier - Clinic/Group Practice 7012811284 Receives reassigned benefits from 2,067 practitioners
24 other NPIs on this enrollment
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…

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 25

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

View all 25

National Provider Directory

National Provider Directory

Locations

205 Marwill Dr
Ste 1
Carrollton, KY 41008
Phone (502) 732-6956

1930 Bishop Ln
Fl 12
Louisville, KY 40218
Phone (502) 272-5220

1930 Bishop Ln
Ste 1600
Louisville, KY 40218
Phone (502) 272-5034

210 E Gray St
Ste 700
Louisville, KY 40202
Phone (502) 629-5400

601 S Floyd St
Ste 350
Louisville, KY 40202
Phone (502) 409-5600

9880 Angies Way
Ste 250
Louisville, KY 40241
Phone (502) 394-6340

Practitioners & affiliated clinicians

Practitioners 2,121

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 2,121

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1306983762",
    "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": "502-588-9490",
            "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": "502-588-9490",
            "fax_number": "502-272-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "GAST",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "VP MANAGED CARE",
        "authorized_official_telephone_number": "502-588-9490"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003882650",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65946279",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65945693",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 3, 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.