NICHOLAS LOUIS HENNICKE – Physical Therapist, NPI 1003639725

NICHOLAS LOUIS HENNICKE is a healthcare provider. based in Cherry hill, New Jersey. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 2012023539 (MO). The NPI Number for NICHOLAS LOUIS HENNICKE is 1003639725

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLAS LOUIS HENNICKE
NPI
1003639725
Phone
Not provided
Address
7 CARNEGIE PLZ
Enumeration Date
1 November 2024
Last Update Date
24 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8774073422
Graduation Year
2012 (14 years ago)
PAC ID
2668907379
Group Practice PAC ID
1254754948
Professional Enrollment ID
I20241118004169
Address ID
MO630904365WA1650XSTXX300

Contacts

Main Contact
https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Other namesUpdated within 12 months

1,533 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MO

Provider Addresses for NICHOLAS LOUIS HENNICKE

  • 7 CARNEGIE PLZ

    CHERRY HILL, NJ 080031000

    Phone:

    Type: Mailing

  • 10199 WOODFIELD LN

    SAINT LOUIS, MO 631322922

    Phone: (877) 407-3422

    Type: Location

  • 1880 Clarkson Rd

    Chesterfield, MO 630175000

    Phone: (636) 536-3800

    Type: Location

  • 1650 High St

    Washington, MO 630904365

    Phone: (877) 407-3422

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241118004169IPhysical Therapist In Private PracticeMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 08003)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254754948View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMO
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeMO
Physical Therapist In Private PracticeMO
Physical Therapist In Private PracticeKY
Physical Therapist In Private PracticeMO
Physical Therapist In Private PracticeMO
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeMO
Physical Therapist In Private PracticeMO

Reviews

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Frequently asked questions

Where can patients find NICHOLAS LOUIS HENNICKE's NPI?
You can confirm NICHOLAS LOUIS HENNICKE with NPI 1003639725; it appears in the national provider directory.
Is NICHOLAS LOUIS HENNICKE active in the national directory?
NICHOLAS LOUIS HENNICKE's public NPI profile is in an active state.
Does NICHOLAS LOUIS HENNICKE list a primary specialty?
If you are matching referrals, note Physical Therapist for NICHOLAS LOUIS HENNICKE. Clinical services aligned with this taxonomy classification.
What location shows for NICHOLAS LOUIS HENNICKE?
We surface Cherry Hill, New Jersey for NICHOLAS LOUIS HENNICKE based on available NPPES addresses.
Is NICHOLAS LOUIS HENNICKE a real provider?
This page reflects official NPPES data for NPI 1003639725. Always confirm identity and privileges with the practice and licensing boards.

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