Mobile Lymphedema Clinic LLC
NPI 1104706837 · Occupational Therapist · Fort Walton Beach, FL
Enrolled with Medicare as Part B Supplier - Physical/Occupational Therapy Group in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mobile Lymphedema Clinic LLC is a Occupational Therapist organization in Fort Walton Beach, FL (NPI 1104706837).
Provider details
- NPI number
- 1104706837
- Entity type
- Organization
- Primary specialty
- Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Jessica Boothe, Owner, Clinician(850) 217-2186
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Hand Occupational Therapist225XH1200X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Gerontology Occupational Therapist225XG0600X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Rehabilitation Practitioner225400000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Ergonomics Occupational Therapist225XE1200X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
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
Under 1 yr in 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
Other names (DBA / former)
- Doing business as
- Move Me Lymphatics-Mobile Lymphedema Clinic
Registry dates
- Enumerated
- 2025-09-04
- Last updated
- 2026-02-18
- Certified
- 2026-02-18
Frequently asked questions
- What is Mobile Lymphedema Clinic LLC's NPI number?
- Mobile Lymphedema Clinic LLC's National Provider Identifier (NPI) is 1104706837, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mobile Lymphedema Clinic LLC?
- Mobile Lymphedema Clinic LLC is classified in the NPPES registry as Occupational Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Mobile Lymphedema Clinic LLC located?
- Mobile Lymphedema Clinic LLC's practice location on file with NPPES is 804 Pine Alley St, Fort Walton Beach, FL 32547-1216.
- What is Mobile Lymphedema Clinic LLC's phone number?
- The practice phone number listed in the NPPES registry for Mobile Lymphedema Clinic LLC is (850) 803-6683.
- Does Mobile Lymphedema Clinic LLC accept Medicare?
- Mobile Lymphedema Clinic 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 Mobile Lymphedema Clinic LLC?
- The authorized official listed on Mobile Lymphedema Clinic LLC's NPPES record is Jessica Boothe, Owner, Clinician. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mobile Lymphedema Clinic LLC's NPI active?
- Yes — Mobile Lymphedema Clinic LLC's NPI (1104706837) is active in the NPPES registry as of the last update on 2026-02-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.