Active Life Physical Therapy
Active Life Physical Therapy is a healthcare organization registered as Physical Therapy Clinic/Center in Madison, MS, holding Type 2 (organization) NPI 1104630144 since 2025. The authorized official on file is Jeremy Kennedy, Physical Therapist.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1104630144 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Active Life Physical Therapy |
| Practice address | 106 CAMDEN TRL, Madison, MS, 39110 |
| Phone | 9856307912 |
| Enumeration date | 2025-02-01 |
| Last updated in NPPES | 2025-02-01 |
Authorized official
| Name | Jeremy Kennedy |
|---|---|
| Title | Physical Therapist |
| Phone | 9856307912 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QP2000X | Physical Therapy Clinic/Center | Primary | — | — |
Copy-ready billing details
Provider: Active Life Physical Therapy NPI: 1104630144 Taxonomy: 261QP2000X (Physical Therapy Clinic/Center) Address: 106 CAMDEN TRL, Madison, MS, 39110
Verify this record
Cross-check NPI 1104630144 against the authoritative CMS record: view Active Life Physical Therapy on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Active Life Physical Therapy?
Who is the authorized official for Active Life Physical Therapy?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-02-01.