PBT LLC

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Legal business name

PBT LLC

Doing business as

PBT
PBT.LLC

Practice address

2404 Willow Park CT
Kissimmee, FL 34758-5007

Phone

(689) 271-5583

NPI assigned

Oct 3, 2022

Organization subpart

No

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

Authorized official

Name

Caranetta Godbolt

Title

Owner

Phone

(689) 271-5583

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• PBT Doing business as
• PBT.LLC Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1598489478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 WILLOW PARK CT",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347585007",
            "telephone_number": "689-271-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 WILLOW PARK CT",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347585007",
            "telephone_number": "689-271-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PBT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "GODBOLT",
        "authorized_official_first_name": "CARANETTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "689-271-5583"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NO",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "peoplebuildingtogetherllc@gmail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2404 Willow Park Ct",
            "city": "Kissimmee",
            "state": "FL",
            "country_code": "US",
            "postal_code": "347585007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PBT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PBT.LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Case Manager/Care Coordinator in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Case Manager/Care Coordinator in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.