Mobile Lymphedema Clinic LLC
NPI 1104706837ActiveOrganization· Occupational Therapist· Fort Walton Beach, FL
Occupational Therapist in Fort Walton Beach, Florida, registered in NPPES in September 2025. The authorized official on file is Jessica Colleen Boothe, MSOT, OTR/L, CLT, Owner, Clinician. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1104706837 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 4, 2025 |
| Last updated in NPPES | Feb 18, 2026 |
| Certified by provider | Feb 18, 2026 |
Specialties and licenses
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (FL) |
|---|
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