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JACOB HENRICKSEN
NPI 1194268771
Chiropractor in Lutz, FL

Active since November 30, 2016
250 CRYSTAL GROVE BLVD, LUTZ, FL 33548(813) 776-1480(813) 807-4774 Get Directions Write a Review

NPPES record last updated: January 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacob Henricksen NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB HENRICKSEN (NPI 1194268771) is an individual chiropractor in Lutz, Florida, licensed in Florida (CH14963) and active in the NPI registry since November 2016. He is a graduate of Other (2016).

NPPES Registry Identity

NPI1194268771
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameJACOB HENRICKSEN
Location Address250 CRYSTAL GROVE BLVDLutz, FL 33548-6460
Mailing Address3043 Boones Creek Rd Ste 107Johnson City, TN 37615-4959
Phone(813) 776-1480
Fax(813) 807-4774
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateNovember 30, 2016
Last NPPES UpdateJanuary 7, 2025
NPPES CertifiedJanuary 7, 2025
✔ NPI 1194268771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in FL · CH14963
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
250 CRYSTAL GROVE BLVD, Lutz, FL 33548
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Henricksen is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6305119793
PECOS Enrollment IDI20250505001103

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chiropractic manipulative treatment, 3-4 spinal regions 98941
Chiropractic manipulative treatment for 3-4 spinal regions involves a trained professional applying controlled force to specific areas of your spine. This can help alleviate pain, improve physical function, and support your body's natural healing process.
161 services11 patients

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HENRICKSEN CHIROPRACTIC, LLC
Chiropractor
250 CRYSTAL GROVE BLVD
LUTZ, FL 33548
Hillsborough County (907) 723-2853

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Henricksen's NPI number?

The NPI number for Jacob Henricksen is 1194268771. It was assigned to this individual provider in the NPPES registry on November 30, 2016.

Where is Jacob Henricksen located?

Jacob Henricksen practices at 250 Crystal Grove Blvd, Lutz, FL 33548. The listed phone number is (813) 776-1480.

What is Jacob Henricksen's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Jacob Henricksen enrolled in Medicare?

Yes. Jacob Henricksen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Henricksen was last updated on January 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.