Nicholas Louis Hennicke

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2012023539 Issued in MO

Practice address

10199 Woodfield LN
Saint Louis, MO 63132-2922

Phone

(877) 407-3422

NPI assigned

Nov 1, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Rehabilitation Services PT Mo LLCGroup PAC ID 1254754948, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fox Rehabilitation Services PT Mo LLC

  • Physical Therapist
  • Saint Charles, MO
  • NPI 1750906095
  Medicare reassignment Care Compare group NPD
• Cadence Physical Therapy LLC

  • Geriatric Physical Therapist
  • Saint Louis, MO
  • NPI 1679405807
  NPD Authorized official

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

{
    "created_epoch": "1730419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1003639725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10199 WOODFIELD LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631322922",
            "telephone_number": "877-407-3422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1880 Clarkson Rd",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630175000",
            "country_code": "US",
            "telephone_number": "636-536-3800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1650 High St",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "MO",
            "postal_code": "630904365",
            "country_code": "US",
            "telephone_number": "877-407-3422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNICKE",
        "first_name": "NICHOLAS",
        "middle_name": "LOUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-01",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2012023539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "FOX REHABILITATION SERVICES PT MO LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10199 Woodfield Ln",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631322922",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "FOX REHABILITATION SERVICES PT MO LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1650 High St",
            "city": "Washington",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630904365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ann Marie Hennessey, M.D.
• James P Hennessey, CRNA
• Margaret Hennessey, PA
• Amy Lynn Hennessy, OT
• Mary Bridget Hennicke, MSW, LCSW
• Bernadette M Henrichs, CRNA
• Jared Henrichs, M.D.
• Sally Jane Henrickson, RN/LCSW
• Belinda Henriksen, APRN, BC
• Henry R. Bollinger, III, DDS, PC

• Physical Therapist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.