Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Corey Nickerson II, PT, DPT

Individual provider Physical Therapist · NPI 1073378097

Corey Nickerson II, PT, DPT is a Physical Therapist in Private Practice in Dallas, Texas. Qualified in 2021, 5 years ago. Practices with Vista Jv Partners LLC, a 126-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
5
Licensed in
TX
In the registry since
2024
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

10233 E Northwest Hwy Ste 410
Dallas, TX 75238-4430
Phone: (469) 221-9203
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1389702 (TX)

Record details

NPI number1073378097
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedFebruary 19, 2024
Last updated in NPPESFebruary 19, 2024
Certification dateFebruary 19, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Vista Jv Partners Llc — 126 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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