Southern Magnolia LLC
NPI 1114693579 · Occupational Therapy Assistant · Fort Myers, FL
Southern Magnolia LLC is a Occupational Therapy Assistant organization in Fort Myers, FL (NPI 1114693579).
Provider details
- NPI number
- 1114693579
- Entity type
- Organization
- Primary specialty
- Occupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Jamie Geerken, Owner(239) 265-5367
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Occupational Therapist225X00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Pediatric Occupational Therapist225XP0200X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Speech-Language Assistant2355S0801X
Speech, Language and Hearing Service Providers
- Speech-Language Pathologist235Z00000X
Speech, Language and Hearing Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
Other names (DBA / former)
- Doing business as
- Southern Magnolia LLC
- Doing business as
- Southern Magnolia LLC
Registry dates
- Enumerated
- 2021-08-17
- Last updated
- 2022-02-23
- Certified
- 2022-02-23
Frequently asked questions
- What is Southern Magnolia LLC's NPI number?
- Southern Magnolia LLC's National Provider Identifier (NPI) is 1114693579, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Magnolia LLC?
- Southern Magnolia LLC is classified in the NPPES registry as Occupational Therapy Assistant (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Southern Magnolia LLC located?
- Southern Magnolia LLC's practice location on file with NPPES is 12856 Banyan Creek Dr # 2, Fort Myers, FL 33908-3082.
- What is Southern Magnolia LLC's phone number?
- The practice phone number listed in the NPPES registry for Southern Magnolia LLC is (239) 265-5367.
- Who is the authorized official for Southern Magnolia LLC?
- The authorized official listed on Southern Magnolia LLC's NPPES record is Jamie Geerken, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Magnolia LLC's NPI active?
- Yes — Southern Magnolia LLC's NPI (1114693579) is active in the NPPES registry as of the last update on 2022-02-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.