Individual provider Active NPI

Keaton E Kramer, D.P.T.

  • Physical Therapist
  • Riverside, CA
National Provider Identifier
1336571108
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT293684 Issued in CA
Practice address
6850 Brockton Ave Ste 212
Riverside, CA 92506-3815
Phone
(951) 534-0600
Fax
(678) 547-6710
NPI assigned
Aug 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT011110 GA
Physical Therapist 225100000X PT293684 CA Primary

Addresses

Primary practice location

6850 Brockton Ave Ste 212
Riverside, CA 92506-3815

Mailing address

24630 Washington Ave Ste 200
Murrieta, CA 92562-6177
Phone (951) 696-9353

Other practice location 1

30141 Antelope Rd Ste A
Menifee, CA 92584-8066
Phone (951) 723-1866

Other practice location 2

10020 Indiana Ave Ste 4
Riverside, CA 92503-5479
Phone (951) 637-2320

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT293684CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
All Star Physical Therapy Physical Therapist CurrentSince Sep 5, 2017 Accepting new patients
Dekalb Comprehensive Physical Therapy Limited Partnership PastSince May 7, 2018 Accepting new patients

Locations

30141 Antelope Rd
Ste A
Menifee, CA 92584
Phone (951) 723-1866

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": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1336571108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24630 WASHINGTON AVE STE 200",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925626177",
            "telephone_number": "951-696-9353",
            "fax_number": "951-973-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 BROCKTON AVE STE 212",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063815",
            "telephone_number": "951-534-0600",
            "fax_number": "678-547-6710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30141 Antelope Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Menifee",
            "state": "CA",
            "postal_code": "925848066",
            "country_code": "US",
            "telephone_number": "951-723-1866",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10020 Indiana Ave Ste 4",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925035479",
            "country_code": "US",
            "telephone_number": "951-637-2320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAMER",
        "first_name": "KEATON",
        "middle_name": "E",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011110",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT293684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.