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Mobile Lymphedema Clinic LLC

Occupational Therapist in Fort Walton Beach, FL · enumerated 2025 · authorized official Jessica Boothe, Owner, Clinician.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1104706837

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Registry record

Entity type Organization (Type 2)
Legal business name Mobile Lymphedema Clinic LLC
Practice address 804 Pine Alley St, Fort Walton Beach, FL, 32547
Phone (850) 803-6683
Fax (888) 857-4412
Enumeration date Sep 4, 2025
Last updated in NPPES Feb 18, 2026

Taxonomy & classification

225400000X Rehabilitation Practitioner Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
225X00000X Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Primary
225XE0001X Environmental Modification Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
225XE1200X Ergonomics Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
225XG0600X Gerontology Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
225XH1200X Hand Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary
225XP0019X Physical Rehabilitation Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Secondary

Authorized official

Name Jessica Boothe
Title Owner, Clinician
Phone (850) 217-2186

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.

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Frequently asked questions

Who is the authorized official for Mobile Lymphedema Clinic LLC?
NPPES lists Jessica Boothe (Owner, Clinician) as the authorized official for this organization.
What is the NPI number for Mobile Lymphedema Clinic LLC?
The NPI for Mobile Lymphedema Clinic LLC is 1104706837, a Type 2 (organization) record in the CMS NPPES registry.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-02-18.