Individual provider Active NPI

James Cody Bothe

  • Addiction (Substance Use Disorder) Counselor
  • Boynton Beach, FL
National Provider Identifier
1942818513
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
SW17425 Issued in FL
Practice address
415 S Federal Hwy
Boynton Beach, FL 33435-4931
Phone
(866) 411-3096
NPI assigned
Jul 20, 2020
Last updated
Oct 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X SW17425 FL Primary

Addresses

Primary practice location

415 S Federal Hwy
Boynton Beach, FL 33435-4931

Mailing address

13046 52ND CT N
Royal Palm Beach, FL 33411-8168
Phone (561) 255-5895

Other practice location 1

700 Colorado Ave
Stuart, FL 34994-3018
Phone (561) 255-5895

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL KIPU

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240628003184 FL Practitioner - Clinical Social Worker 6103360359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Florida Atlantic University, College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychiatric Care Florida LLCGroup PAC ID 0941608731, 15 clinicians

Practice addresses (Care Compare)

1903 S Congress Ave
Suite 455
Boynton Beach, FL 33426-6559
Phone (561) 336-4790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW17425FLMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Care Florida, LLC Single Specialty CurrentSince Jun 21, 2024 Accepting new patients
Iop Now Inc. PastSince Jun 21, 2024 Accepting new patients

Locations

1903 S Congress Ave
Ste 455
Boynton Beach, FL 33426
Phone (561) 255-5895

809 N Dixie Hwy
Ste 200
West Palm Beach, FL 33401
Phone (561) 336-4790

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1942818513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13046 52ND CT N",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334118168",
            "telephone_number": "561-255-5895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S FEDERAL HWY",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334354931",
            "telephone_number": "866-411-3096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Colorado Ave",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "349943018",
            "country_code": "US",
            "telephone_number": "561-255-5895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTHE",
        "first_name": "JAMES",
        "middle_name": "CODY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-20",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "SW17425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "KIPU",
            "affiliation": "N",
            "address_1": "415 S Federal Hwy",
            "city": "Boynton Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334354931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.