Organization Active NPI

The Lymphedema Center, LLC

  • Physical Rehabilitation Occupational Therapist
  • Tifton, GA
National Provider Identifier
1013710441
Registry record updated Apr 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
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

Updated by the provider on Apr 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brandy McKeown, OTR/L, CLT-LANANPI 1255348579
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)CodeLicenseStatePrimary
Physical Rehabilitation Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
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 Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

Verify at the official NPI Registry.