Impact Physical Therapy, LLC
NPI 1174709430 · Physical Therapist · Lebanon, TN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Impact Physical Therapy, LLC is a Physical Therapist organization in Lebanon, TN (NPI 1174709430).
Provider details
- NPI number
- 1174709430
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- John Boucher, Owner(615) 453-1422
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs 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
- 2008-01-17
- Last updated
- 2023-05-12
- Certified
- 2023-05-12
Frequently asked questions
- What is Impact Physical Therapy, LLC's NPI number?
- Impact Physical Therapy, LLC's National Provider Identifier (NPI) is 1174709430, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Impact Physical Therapy, LLC?
- Impact Physical Therapy, LLC is classified in the NPPES registry as Physical Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Impact Physical Therapy, LLC located?
- Impact Physical Therapy, LLC's practice location on file with NPPES is 1430 W Baddour Pkwy, Lebanon, TN 37087-2514.
- What is Impact Physical Therapy, LLC's phone number?
- The practice phone number listed in the NPPES registry for Impact Physical Therapy, LLC is (615) 453-1422.
- Does Impact Physical Therapy, LLC accept Medicare?
- Impact Physical Therapy, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Impact Physical Therapy, LLC?
- The authorized official listed on Impact Physical Therapy, LLC's NPPES record is John Boucher, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Impact Physical Therapy, LLC's NPI active?
- Yes — Impact Physical Therapy, LLC's NPI (1174709430) is active in the NPPES registry as of the last update on 2023-05-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.