Individual provider Active NPI

Diturije Kerimi

  • Behavior Technician
  • Port Charlotte, FL
National Provider Identifier
1952176604
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
21503 Olean Blvd
Port Charlotte, FL 33952-5481
Phone
(941) 473-6722
NPI assigned
Nov 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

21503 Olean Blvd
Port Charlotte, FL 33952-5481

Mailing address

8270 Burnt Store Rd Unit 3
Punta Gorda, FL 33950-4705
Phone (941) 456-0018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Strategic Applied Behavior Analysis Corp CurrentSince Nov 26, 2023 Accepting new patients

Locations

8270 Burnt Store Rd
Unit 3
Punta Gorda, FL 33950
Phone (941) 456-0018

Organizations & group practices 1

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": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1952176604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8270 BURNT STORE RD UNIT 3",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339504705",
            "telephone_number": "941-456-0018",
            "fax_number": "239-900-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21503 OLEAN BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525481",
            "telephone_number": "941-473-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERIMI",
        "first_name": "DITURIJE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-21",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.