OrganizationActive
Independent Physical Therapy, LLC
NPI 1962743674 · Physical Therapy Clinic/Center · Covington, GA
Provider details
- NPI number
- 1962743674
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kevin Johanneson, Vp Revenue Cycle(423) 238-2313
Specialties & taxonomies
Ambulatory Health Care Facilities
- Occupational Medicine Clinic/Center261QX0100X
Ambulatory Health Care Facilities
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
11172 Highway 142 N
Covington, GA 30014-2547
Phone: (678) 712-3692
Fax: (678) 712-3693
Street-level locationGet directions
Mailing address
6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Additional practice locations (1)
- 11186 Highway 142 NCovington, GA 30014-2547Phone: (678) 712-3692
Registry dates
- Enumerated
- 2013-03-05
- Last updated
- 2018-11-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.