MOBILE LYMPHEDEMA CLINIC LLC
NPI 1104706837
Occupational Therapist in Fort Walton Beach, FL
About Mobile Lymphedema Clinic Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MOBILE LYMPHEDEMA CLINIC LLC (NPI 1104706837), doing business as Move Me Lymphatics-mobile Lymphedema Clinic, is a healthcare organization registered as an occupational therapist in Fort Walton Beach, Florida and active in the NPI registry since September 2025. The organization lists Jessica Colleen Boothe, Owner, Clinician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 7
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mobile Lymphedema Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Mobile Lymphedema Clinic LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mobile Lymphedema Clinic LLC's NPI number?
The NPI number for Mobile Lymphedema Clinic LLC is 1104706837. It was assigned to this organization in the NPPES registry on September 4, 2025. The provider is doing business as Move Me Lymphatics-Mobile Lymphedema Clinic.
Where is Mobile Lymphedema Clinic LLC located?
Mobile Lymphedema Clinic LLC is located at 804 Pine Alley St, Fort Walton Beach, FL 32547. The listed phone number is (850) 803-6683.
What is Mobile Lymphedema Clinic LLC's specialty?
The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.
Is Mobile Lymphedema Clinic LLC enrolled in Medicare?
Yes. Mobile Lymphedema Clinic LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mobile Lymphedema Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Occupational Therapist in Private Practice) reassigns their Medicare billing to Mobile Lymphedema Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Mobile Lymphedema Clinic LLC was last updated on February 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.