Mobile Lymphedema Clinic LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

MOBILE LYMPHEDEMA CLINIC LLC

Practice address

804 Pine Alley St
Fort Walton Beach, FL 32547-1216

Phone

(850) 803-6683

Fax

(888) 857-4412

NPI assigned

Sep 4, 2025

Organization subpart

No

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

Authorized official

Name

Jessica Colleen Boothe, MSOT, OTR/L, CLTNPI 1194006601

Title

Owner, Clinician

Phone

(850) 217-2186

Specialties & licenses 7

Addresses

Other names 1

• Move Me Lymphatics-Mobile Lymphedema Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

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

• Jessica C Boothe, MSOT, OTR/L, CLT

  • Occupational Therapist
  • Fort Walton Beach, FL
  • NPI 1194006601

  Multi-Specialty

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1104706837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 PINE ALLEY ST",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471216",
            "telephone_number": "850-803-6683",
            "fax_number": "888-857-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 PINE ALLEY ST",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471216",
            "telephone_number": "850-803-6683",
            "fax_number": "888-857-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE LYMPHEDEMA CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-04",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A",
        "authorized_official_last_name": "BOOTHE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "COLLEEN",
        "authorized_official_title_or_position": "OWNER, CLINICIAN",
        "authorized_official_telephone_number": "850-217-2186",
        "authorized_official_credential": "MSOT, OTR/L, CLT"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XE0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XE1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Ergonomics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Move Me Lymphatics-Mobile Lymphedema Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Don E Miller, CRNA
• Michael Lee Miller, M.D.
• Heather Mills, OTR/L
• John Edwin Mills, M.D.
• Sandra Mims
• Jessica Mohammed, MD
• Kelsey Lauren Money, AUD
• Alexis A Monroe, LMT
• Rebecca Montgomery, LMT
• Barbaro Montiel Lugo

• Occupational Therapist in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; 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.