Individual provider Active NPI

Steven M Hennig, PT, DPT

  • Physical Therapist
  • Coral Springs, FL
National Provider Identifier
1417445990
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11919R Issued in LA
Practice address
5830 Coral Ridge Dr Ste 300
Coral Springs, FL 33076-3388
Phone
(866) 425-5768
NPI assigned
Apr 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01716300 NJ
Physical Therapist 225100000X 11919R LA Primary

Addresses

Primary practice location

5830 Coral Ridge Dr Ste 300
Coral Springs, FL 33076-3388

Mailing address

1667 Grasscreek Dr
San Dimas, CA 91773-1316
Phone (909) 957-5494

Other practice location 1

1001 School St
Houma, LA 70360-4629
Phone (985) 868-1540

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
11919RLAMDPhysical Therapist
40QA01716300NJMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1417445990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1667 GRASSCREEK DR",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731316",
            "telephone_number": "909-957-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5830 CORAL RIDGE DR STE 300",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763388",
            "telephone_number": "866-425-5768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 School St",
            "address_purpose": "LOCATION",
            "city": "Houma",
            "state": "LA",
            "postal_code": "703604629",
            "country_code": "US",
            "telephone_number": "985-868-1540",
            "fax_number": "985-876-0759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNIG",
        "first_name": "STEVEN",
        "middle_name": "M",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-30",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01716300",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "11919R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.