Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Holly Long, PT

Individual provider Physical Therapist · NPI 1649403924

Holly Long, PT is a Physical Therapist in Private Practice in Jefferson City, Tennessee. Qualified in 1995, 31 years ago. Practices with Summit Medical Group, PLLC, a 636-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Tennessee and West Virginia.

Years since qualifying
31
Licensed in
TN, WV
In the registry since
2009
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

380 W Broadway Blvd Ste 130
Jefferson City, TN 37760-2602
Phone: (865) 475-4742
Fax: (833) 908-2080
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • Route 10, Three Mile Curve Road, Logan, WV 25601 — (304) 752-2273

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 12118 (TN)
Physical Therapist Taxonomy 225100000X · Licence 1441 (WV)

Record details

NPI number1649403924
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorYes
NPI enumeratedSeptember 2, 2009
Last updated in NPPESAugust 24, 2023
Certification dateAugust 24, 2023
Mailing address1275 Dick Lonas Rd Unit 101, Knoxville, TN 37909-1383

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Summit Medical Group, Pllc — 636 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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