Active NPI
The Lymphedema Center, LLC
- Physical Rehabilitation Occupational Therapist
- Tifton, GA
National Provider Identifier
1013710441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- Legal business name
- THE LYMPHEDEMA CENTER, LLC
- Practice address
- 1401 US Highway 41 N
Tifton, GA 31794-3203 - Phone
- (229) 387-8377
- Fax
- (229) 387-8370
- NPI assigned
- Mar 31, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brandy McKeown, OTR/L, CLT-LANA
- Title
- President
- Phone
- (229) 848-0050
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | Primary |
Addresses
Primary practice location
1401 US Highway 41 N
Tifton, GA 31794-3203
Mailing address
1401 US Highway 41 N
Tifton, GA 31794-3203
Phone (229) 387-8377
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250424000170 | GA | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 2062938996 |
Receives reassigned benefits from 1 practitioner Practice locations: Tifton, GA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Occupational Therapist
- Tifton, GA
- NPI 1083231567
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743379200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1745020800000",
"number": "1013710441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 US HIGHWAY 41 N",
"city": "TIFTON",
"state": "GA",
"postal_code": "317943203",
"telephone_number": "229-387-8377",
"fax_number": "229-387-8370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 US HIGHWAY 41 N",
"city": "TIFTON",
"state": "GA",
"postal_code": "317943203",
"telephone_number": "229-387-8377",
"fax_number": "229-387-8370"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE LYMPHEDEMA CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-03-31",
"last_updated": "2025-04-19",
"certification_date": "2025-04-19",
"status": "A",
"authorized_official_last_name": "MCKEOWN",
"authorized_official_first_name": "BRANDY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "229-848-0050",
"authorized_official_credential": "OTR/L, CLT-LANA"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tifton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.