COREY NICKERSON II (PT, DPT) – Physical Therapist, NPI 1073378097

COREY NICKERSON II (PT, DPT) is a healthcare provider. based in Forney, Texas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. 1389702 (TX). The NPI Number for COREY NICKERSON II (PT, DPT) is 1073378097

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
COREY NICKERSON II (PT, DPT)
NPI
1073378097
Phone
Not provided
Address
1701 EVERGLADES DR
Enumeration Date
19 February 2024
Last Update Date
19 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6822450631
Graduation Year
2021 (5 years ago)
PAC ID
9830536358
Group Practice PAC ID
2769723162
Professional Enrollment ID
I20240320000925
Address ID
TX762449635FO9901XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

5,355 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TX

Provider Addresses for COREY NICKERSON II (PT, DPT)

  • 1701 EVERGLADES DR

    FORNEY, TX 751263464

    Phone:

    Type: Mailing

  • 10233 E NORTHWEST HWY STE 410

    DALLAS, TX 752384430

    Phone: (469) 221-9203

    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: 2024-03-20

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
I20240320000925IPhysical Therapist In Private PracticeTXTBD

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 75126)

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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: 2769723162View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeAZ
Qualified Speech Language PathologistWI
Physical Therapist In Private PracticePA
Family PracticeTN
Occupational Therapist In Private PracticeNC
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticeID
Physical Therapist In Private PracticeVA
Occupational Therapist In Private PracticeAZ
Occupational Therapist In Private PracticePA

Reviews

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Frequently asked questions

Where can patients find COREY NICKERSON II (PT, DPT)'s NPI?
You can confirm COREY NICKERSON II (PT, DPT) with NPI 1073378097; it appears in the national provider directory.
Is COREY NICKERSON II (PT, DPT)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does COREY NICKERSON II (PT, DPT) treat or focus on?
Patients typically see COREY NICKERSON II (PT, DPT) under the specialty Physical Therapist. Clinical services aligned with this taxonomy classification.
Where is COREY NICKERSON II (PT, DPT)'s primary listing?
We display Forney, Texas because that is what the record indicates for COREY NICKERSON II (PT, DPT).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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