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

Dr. Jennifer Hicks, DPT

Individual provider Physical Therapist · NPI 1104354554

Dr. Jennifer Hicks, DPT is a Physical Therapist in Private Practice in Stafford, Virginia. Qualified in 2017, 9 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
9
Licensed in
VA
In the registry since
2017
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

2777 Jefferson Davis Hwy Ste 109
Stafford, VA 22554-8323
Phone: (540) 318-8615
Fax: (540) 318-8619
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 616 Garrisonville Rd, Stafford, VA 22554-3707 — (540) 628-4612

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2305211081 (VA)

Record details

NPI number1104354554
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPT
Sole proprietorYes
NPI enumeratedMay 30, 2017
Last updated in NPPESJuly 21, 2022
Certification dateMarch 18, 2022
Mailing addressPo Box 791217, Baltimore, MD 21279-1217

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Stafford