Active NPI
John Dickens, MD, MBA
- Emergency Medicine Physician
- Louisville, KY
National Provider Identifier
1902463706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 61631
- Practice address
- 1 Audubon Plaza Dr
Louisville, KY 40217-1318 - Phone
- (502) 636-7225
- Fax
- (502) 636-8032
- NPI assigned
- May 28, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 61631 | KY | Primary |
| Emergency Medicine Physician | 207P00000X | 125.080446 | IL |
Addresses
Primary practice location
1 Audubon Plaza Dr
Louisville, KY 40217-1318
Mailing address
PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490
Other practice location 1
251 E Huron St
Chicago, IL 60611-2908
Phone (312) 926-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220610002138 | IL | Order and Referring Only - Emergency Medicine | 8022496538 |
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of Louisville School of Medicine, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1951 Bishop LN
FL 4
Louisville, KY 40218-1923
PO Box
Suite 776351
Chicago, IL 60677-6351
Hospital & facility affiliations
- Northwestern Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Business Administration, Doctor of Medicine
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1497859649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782691200000",
"number": "1902463706",
"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": "1 AUDUBON PLAZA DR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402171318",
"telephone_number": "502-636-7225",
"fax_number": "502-636-8032"
}
],
"practiceLocations": [
{
"address_1": "251 E Huron St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606112908",
"country_code": "US",
"telephone_number": "312-926-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DICKENS",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "MD, MBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-28",
"last_updated": "2026-06-29",
"certification_date": "2026-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "KY",
"license": "61631",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "125.080446",
"primary": false
}
],
"identifiers": [],
"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 Jun 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.