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

Nicholas Louis Hennicke

Individual provider Physical Therapist · NPI 1003639725

Nicholas Louis Hennicke is a Physical Therapist in Private Practice in Saint Louis, Missouri. Qualified in 2012, 14 years ago. Practices with Fox Rehabilitation Services PT Mo LLC, a 32-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
14
Licensed in
MO
In the registry since
2024
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Practice location Address checks out

10199 Woodfield Ln
Saint Louis, MO 63132-2922
Phone: (877) 407-3422
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1880 Clarkson Rd, Chesterfield, MO 63017-5000 — (636) 536-3800
  • 1650 High St, Washington, MO 63090-4365 — (877) 407-3422

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2012023539 (MO)

Record details

NPI number1003639725
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 1, 2024
Last updated in NPPESFebruary 24, 2025
Certification dateFebruary 24, 2025

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Fox Rehabilitation Services Pt Mo Llc — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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