Active Life Physical Therapy
NPI 1104630144 · Physical Therapy Clinic/Center · Madison, MS
Active Life Physical Therapy is a Physical Therapy Clinic/Center organization in Madison, MS (NPI 1104630144).
Provider details
- NPI number
- 1104630144
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jeremy Kennedy, Physical Therapist(985) 630-7912
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-02-01
- Last updated
- 2025-02-01
- Certified
- 2025-01-31
Frequently asked questions
- What is Active Life Physical Therapy's NPI number?
- Active Life Physical Therapy's National Provider Identifier (NPI) is 1104630144, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Active Life Physical Therapy?
- Active Life Physical Therapy is classified in the NPPES registry as Physical Therapy Clinic/Center (Ambulatory Health Care Facilities).
- Where is Active Life Physical Therapy located?
- Active Life Physical Therapy's practice location on file with NPPES is 106 Camden Trl, Madison, MS 39110-6601.
- What is Active Life Physical Therapy's phone number?
- The practice phone number listed in the NPPES registry for Active Life Physical Therapy is (985) 630-7912.
- Who is the authorized official for Active Life Physical Therapy?
- The authorized official listed on Active Life Physical Therapy's NPPES record is Jeremy Kennedy, Physical Therapist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Active Life Physical Therapy's NPI active?
- Yes — Active Life Physical Therapy's NPI (1104630144) is active in the NPPES registry as of the last update on 2025-02-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.