MOBILE LYMPHEDEMA CLINIC LLC
MOBILE LYMPHEDEMA CLINIC LLC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1104706837, based in Fort Walton Beach, FL. The organization lists 7 taxonomy classifications, with Occupational Therapist recorded as primary.
Getting there
The practice address on file is 804 PINE ALLEY ST, Fort Walton Beach, FL 32547. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
NPPES does not list a state licence number for this record. That is not unusual — organizations and some provider types are not required to file one. Verify current licensure with the relevant state board before care.
- Status
- Approved
- Provider type
- Part B Supplier - Physical/occupational Therapy Group In Private Practice
- PAC ID
- 1456841246
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Physical/occupational Therapy Group In Private Practice. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Occupational Therapist covers
An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. NUCC Health Care Provider Taxonomy, code 225X00000X
All registered taxonomy codes
This provider registers 7 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | — | — | primary |
| 225XH1200X | Hand Occupational Therapist Hand | — | — | |
| 225XG0600X | Gerontology Occupational Therapist Gerontology | — | — | |
| 225400000X | Rehabilitation Practitioner | — | — | |
| 225XE1200X | Ergonomics Occupational Therapist Ergonomics | — | — | |
| 225XP0019X | Physical Rehabilitation Occupational Therapist Physical Rehabilitation | — | — | |
| 225XE0001X | Environmental Modification Occupational Therapist Environmental Modification | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1104706837 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Sep 4, 2025 |
| Last updated | Feb 18, 2026 |
| Status | Active |
| Practice address |
804 PINE ALLEY ST Fort Walton Beach, FL 32547 (850) 803-6683 Fax (888) 857-4412 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 0 | 4 | 7 | 0 | 6 | 8 | 3 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 0 | 4 | 5 | 0 | 3 | 8 | 6 |
Sum = 53 · next multiple of 10 = 60 · check digit = 7 · actual last digit = 7
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.