Active NPI
Nikia Rene Chennault, PT, DPT, MPH
- Physical Therapist
- Petersburg, VA
National Provider Identifier
1164101424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305214582
- Practice address
- 95 Medical Park Blvd
Petersburg, VA 23805-9280 - Phone
- (804) 504-8100
- NPI assigned
- Jul 13, 2023
- Last updated
- Jun 1, 2026
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 14052 | MN | |
| Physical Therapist | 225100000X | 2305214582 | VA | Primary |
| Physical Therapist | 225100000X | PT033428 | PA |
Addresses
Primary practice location
95 Medical Park Blvd
Petersburg, VA 23805-9280
Mailing address
95 Medical Park Blvd
Petersburg, VA 23805-9280
Phone (804) 504-8100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT033428 | PA | MD | Physical Therapist |
| 2305214582 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780272000000",
"number": "1164101424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 MEDICAL PARK BLVD",
"city": "PETERSBURG",
"state": "VA",
"postal_code": "238059280",
"telephone_number": "804-504-8100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 MEDICAL PARK BLVD",
"city": "PETERSBURG",
"state": "VA",
"postal_code": "238059280",
"telephone_number": "804-504-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHENNAULT",
"first_name": "NIKIA",
"middle_name": "RENE",
"credential": "PT, DPT, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-13",
"last_updated": "2026-06-01",
"certification_date": "2026-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "14052",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305214582",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT033428",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petersburg, VA
- Chambers of Love Transportation LLC
- Chappell & Partners Non Emergency Medical Transportation, LLC
- Tamara Charity-Brown, M.D.
- Angela Cheatham, PA-C
- Catherine E Cheek, NP
- Childrens Endodontic Services, PC (Dr. Paula Nesbitt)
- Chiro One Wellness Center of Petersburg LLC
- Vijaya Lakshmi Chirumamilla, M.D.
- Heather Chong, RPH
- Shauna Holland Christian, LPC, CSAC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.