Jenny Fern Hicks, DOCTORATE OF PT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

PT-260 Issued in ID

Practice address

1905 Pine St
Sandpoint, ID 83864-8311

Phone

(208) 263-7998

NPI assigned

May 17, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advance Physical Therapy PAGroup PAC ID 3173682168, 3 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.

• Advance Physical Therapy PA

  • Physical Therapist
  • Sandpoint, ID
  • NPI 1871743575
  Medicare reassignment Care Compare group NPD
• Sandpoint Physical Therapy PC

  • Physical Therapist
  • Sandpoint, ID
  • NPI 1558828020
  Medicare reassignment NPD

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1578090833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 PINE ST",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838648311",
            "telephone_number": "208-263-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 PINE ST",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838648311",
            "telephone_number": "208-263-7998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "JENNY",
        "middle_name": "FERN",
        "credential": "DOCTORATE OF PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-17",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "ID",
            "license": "PT-260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE NUMBER",
            "identifier": "PT-260",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Camille Henker, O.D.
• Patricia Jane Hennessy, MD
• Amber Renee Henrickson, LCSW
• Mark Edward Hernandez, M.D.
• Grace Hickox-Carriere, LPC
• Jill Kathryn Hicks, LCPC
• Bruce Whitley Honsinger, MD
• Holly Ann Hoopes-Langenfeld, LCSW
• Jane E Hoover, RN MSN FNP
• Todd Michael House, DMD

• Geriatric Physical Therapist in Sandpoint, ID
• Providers in Sandpoint, ID by specialty
• Geriatric Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.