Individual provider Active NPI

Cali Kervin

  • Clinical Social Worker
  • North Port, FL
National Provider Identifier
1467196014
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW19519 Issued in FL
Practice address
2574 Commerce Pkwy
North Port, FL 34289-9334
Phone
(941) 485-0121
Fax
(941) 485-0591
NPI assigned
Apr 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW19519 FL Primary

Addresses

Primary practice location

2574 Commerce Pkwy
North Port, FL 34289-9334

Mailing address

PO Box 631278
Cincinnati, OH 45263-1278
Phone (941) 485-0121

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
I20231211001990 FL Practitioner - Clinical Social Worker 3173972569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dna Comprehensive Therapy Services LLCGroup PAC ID 2860619632, 446 clinicians

Practice addresses (Care Compare)

1602 Oakfield Dr
Suite 205
Brandon, FL 33511-0827
Phone (813) 655-6367

Merit-based Incentive Payment System (MIPS)

Final score
87.43 of 100Reported as group
Quality
74.02
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW19519FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC Clinical CurrentSince Jan 1, 2024 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

1602 Oakfield Dr
Ste 205
Brandon, FL 33511
Phone (813) 655-6367

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

11349 Cortez Blvd
Spring Hill, FL 34613
Phone (352) 597-0022

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Interoperability endpoints

  • Direct secure messaging: cali.kervin.1@13142.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1467196014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631278",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631278",
            "telephone_number": "941-485-0121",
            "fax_number": "941-485-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2574 COMMERCE PKWY",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342899334",
            "telephone_number": "941-485-0121",
            "fax_number": "941-485-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERVIN",
        "first_name": "CALI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Port, FL

Sources for this page

Verify at the official NPI Registry.