NPIMap

Organization Active NPI

Norton Children's Medical Group, LLC

  • Pediatric Cardiology Physician
  • Louisville, KY
National Provider Identifier
1710528336
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
NORTON CHILDREN'S MEDICAL GROUP, LLC
Practice address
4803 Olympia Park PLZ Ste 1100
Louisville, KY 40241-3068
Phone
(502) 272-5335
Fax
(502) 272-5339
NPI assigned
Oct 4, 2019
Last updated
Sep 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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 9

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X
Surgical Physician Assistant 363AS0400X
Nurse Practitioner 363L00000X
Family Nurse Practitioner 363LF0000X
Social Worker 104100000X
Clinical Social Worker 1041C0700X
Clinical Cardiac Electrophysiology Physician 207RC0001X
Pediatric Cardiology Physician 2080P0202X Primary

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 Cardiology Former legal business name

Medicare participation

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

Enrollment records 2

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
O20200309001084 IN Part B Supplier - Clinic/Group Practice 3779917596 Receives reassigned benefits from 93 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Madison, IN; Scottsburg, IN; New Albany, IN; Jeffersonville, IN; Jasper, IN; Evansville, IN; Corydon, IN; Clarksville, IN

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

Locations

1919 State St
Ste 103
New Albany, IN 47150
Phone (812) 801-0800

1858 Old Lebanon Rd
Campbellsville, KY 42718
Phone (270) 465-0632

1 Trillium Way
Ste 306
Corbin, KY 40701

3026 Poplar Level Rd
Louisville, KY 40217
Phone (502) 636-4929

411 E Chestnut St
#7
Louisville, KY 40202
Phone (502) 588-3400

6420 Dutchmans Pkwy
Ste 80
Louisville, KY 40205

300 S 8th St
Ste 208E
Murray, KY 42071
Phone (270) 759-9223

2501 Kentucky Ave
Ste 102
Paducah, KY 42003

150 Frankfort Rd
Ste 102C
Shelbyville, KY 40065
Phone (502) 882-8414

112 Tradepark Dr
Somerset, KY 42503
Phone (606) 451-3755

Practitioners & affiliated clinicians

Practitioners 45

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 45

NPI Registry JSON

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632268800000",
    "number": "1710528336",
    "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": "502-272-5335",
            "fax_number": "502-272-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTON CHILDREN'S MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-04",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "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": "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": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Norton Children's Cardiology",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Norton Children's Cardiology",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Sep 22, 2021; 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.