NPIMap

Individual provider Active NPI

Dwayne Likens, DO

  • Family Medicine Physician
  • Louisville, KY
National Provider Identifier
1326336793
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04064 Issued in KY
Practice address
200 E Chestnut St BLDG Suite303
Louisville, KY 40202
Phone
(502) 629-5552
Fax
(502) 629-3132
NPI assigned
Jul 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2827 TN
Family Medicine Physician 207Q00000X 0102204025 VA
Family Medicine Physician 207Q00000X 04064 KY Primary

Addresses

Primary practice location

200 E Chestnut St BLDG Suite303
Louisville, KY 40202

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other practice location 1

1990 Holton Ave E
Big Stone Gap, VA 24219-3350
Phone (276) 679-1383

Other practice location 2

200 E Chestnut St Bldg Suite303
Louisville, KY 40202-1831
Phone (502) 629-5552

Other identifiers 3

IdentifierTypeStateIssuer
7100418380MedicaidKY
300032286MedicaidIN
K239373OtherKYMEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dlikens167835@direct.nortonhealthcare.org
FHIR URL https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151214000514 TN Practitioner - Family Practice 3870894090 Reassigns benefits to 4 organizations
I20170703001167 KY Practitioner - Internal Medicine 3870894090 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Physician Group, Tennessee LLCGroup PAC ID 3476051525, 10 clinicians
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

1240 S Germantown Rd
Germantown, TN 38138-2226
Phone (901) 275-3300

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 893-1270

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 893-1270

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088
  • Ascension Saint Thomas Hospital Hospital, Nashville, TN, CCN 440082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
04064KYMDFamily Medicine Physician
0102204025VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Oct 7, 2019 Accepting new patients
Community Medical Associates, Inc. Family Medicine CurrentSince Oct 7, 2019 Accepting new patients
Wellmont Medical Associates Inc Family Medicine CurrentSince Jan 1, 2016 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Aug 8, 2017 Accepting new patients
Cogent Healthcare of Kentucky, PSC Family Medicine CurrentSince Oct 31, 2018 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
24 On Physicians, PC CurrentSince May 22, 2017 Accepting new patients
Southeastern Physician Services PC CurrentSince Aug 1, 2018 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Aug 8, 2017 Accepting new patients
App of Tennessee HM, PLLC CurrentSince Sep 17, 2021 Accepting new patients
24 On Physicians, P.C. CurrentSince May 22, 2017 Accepting new patients
Impact Physician Group, Tennessee LLC CurrentSince Jan 5, 2026 Accepting new patients
Norton Hospitals, Inc Past Accepting new patients

Locations

4305 New Shepherdsville Rd
Bardstown, KY 40004
Phone (502) 350-5000

217 S 3rd St
Danville, KY 40422
Phone (859) 239-1000

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

200 E Chestnut St
Ste 303
Louisville, KY 40202
Phone (502) 629-5552

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

801 Eastern Byp
Richmond, KY 40475
Phone (606) 623-3131

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

400 E Tickle St
Dyersburg, TN 38024
Phone (731) 285-2410

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

310 21st Ave N
Nashville, TN 37203
Phone (629) 253-5300

2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1326336793",
    "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": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E CHESTNUT ST BLDG SUITE303",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40202",
            "telephone_number": "502-629-5552",
            "fax_number": "502-629-3132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1990 Holton Ave E",
            "address_purpose": "LOCATION",
            "city": "Big Stone Gap",
            "state": "VA",
            "postal_code": "242193350",
            "country_code": "US",
            "telephone_number": "276-679-1383",
            "fax_number": "276-679-1851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 E Chestnut St Bldg Suite303",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021831",
            "country_code": "US",
            "telephone_number": "502-629-5552",
            "fax_number": "502-629-3132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIKENS",
        "first_name": "DWAYNE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "2827",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102204025",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "04064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100418380",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300032286",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K239373",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dlikens167835@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "200 E Chestnut St Bldg Suite303",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021831",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "200 E Chestnut St Bldg Suite303",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.