Individual provider Active NPI

Wayne Oliver Wolverton, DO

  • Internal Medicine Physician
  • Fort Knox, KY
National Provider Identifier
1790941334
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04033 Issued in KY
Practice address
200 Brule St
Fort Knox, KY 40121-6100
Phone
(502) 626-9789
Fax
(502) 624-0482
NPI assigned
Aug 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 04033 KY
Internal Medicine Physician 207R00000X 04033 KY Primary

Addresses

Primary practice location

200 Brule St
Fort Knox, KY 40121-6100

Mailing address

5410 Maryland Way Ste 300
Brentwood, TN 37027-5339
Phone (615) 377-5602

Other practice location 1

4305 New Shepherdsville Rd
Bardstown, KY 40004-9019
Phone (502) 350-5000

Other names 1

  • Wayne O Wolverton Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180306000404 KY Practitioner - Internal Medicine 5991926529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Practice addresses (Care Compare)

1301 N Race St
Glasgow, KY 42141-3454
Phone (270) 651-4471

4305 New Shepherdsville Rd
Bardstown, KY 40004-9019
Phone (502) 350-5000

Hospital & facility affiliations

  • CHI Saint Joseph Flaget Memorial Hospital Hospital, Bardstown, KY, CCN 180025
  • Saint Joseph London Hospital, London, KY, CCN 180011
  • T J Samson Community Hospital Hospital, Glasgow, KY, CCN 180017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04033KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Kentucky, PSC Internal Medicine CurrentSince Sep 1, 2018 Accepting new patients
Southeastern Physician Services PC Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
Hospitalist Medicine Physicians of Indiana, LLC Internal Medicine CurrentSince May 19, 2021 Accepting new patients
Flaget Healthcare, Inc Past Accepting new patients
Saint Joseph Health System, Inc Past Accepting new patients
Saint Joseph Health System, Inc Past Accepting new patients

Locations

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

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

1 Saint Joseph Dr
Lexington, KY 40504
Phone (502) 350-5000

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

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

1001 Saint Joseph Ln
London, KY 40741
Phone (606) 330-6000

360 Amsden Ave
Versailles, KY 40383
Phone (606) 873-3111

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1790941334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 MARYLAND WAY STE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275339",
            "telephone_number": "615-377-5602",
            "fax_number": "615-271-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BRULE ST",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401216100",
            "telephone_number": "502-626-9789",
            "fax_number": "502-624-0482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4305 New Shepherdsville Rd",
            "address_purpose": "LOCATION",
            "city": "Bardstown",
            "state": "KY",
            "postal_code": "400049019",
            "country_code": "US",
            "telephone_number": "502-350-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLVERTON",
        "first_name": "WAYNE",
        "middle_name": "OLIVER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "KY",
            "license": "04033",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "04033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WAYNE",
            "last_name": "WOLVERTON",
            "middle_name": "O",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Knox, KY

Sources for this page

Verify at the official NPI Registry.