Amanda Dittmer, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN9268426 Issued in FL

Practice address

3191 Harbor Blvd Ste B
Port Charlotte, FL 33952-6755

Phone

(941) 883-4518

NPI assigned

Jul 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dna Comprehensive Therapy Services LLCGroup PAC ID 2860619632, 446 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amanda.dittmer.1@13142.direct.athenahealth.com

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

• Dna Comprehensive Therapy Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Myers, FL
  • NPI 1316363757
  Medicare reassignment Care Compare group NPD
• Bonita Springs Retirement Village, Inc.

  • Skilled Nursing Facility
  • Bonita Springs, FL
  • NPI 1700126802
  NPD

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1134572274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 TECHSTER BLVD STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339664805",
            "telephone_number": "239-236-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 HARBOR BLVD STE B",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526755",
            "telephone_number": "941-883-4518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTMER",
        "first_name": "AMANDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9268426",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN9268426",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100028500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul L Digiorgi, MD
• Christina Dill, BCBA
• Brittany Diltz, PTA
• Diluv Acupuncture Enteerprises Inc
• Vladimir J Dinolov, MD
• Divine Care of Port Charlotte
• Divinity Group, Inc.
• Jamie Dixon
• Mya Dixon, BEHAVIOR TECHNICIAN
• DME Plus Inc

• Psychiatric/Mental Health Nurse Practitioner in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.