Traci R Williams, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

22968 Issued in CA

Practice address

12241 Industrial Blvd Ste 210
Victorville, CA 92395-8301

Phone

(800) 489-6905

Fax

(626) 294-0080

NPI assigned

Sep 1, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arroyo Physical TherapyGroup PAC ID 5799969812, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Arroyo Physical Therapy

  • Physical Therapy Clinic/Center
  • Pasadena, CA
  • NPI 1669787495

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Albert Babanian, Inc.

  dba Active Moving Body Physical Therapy

  • Physical Therapist
  • Glendale, CA
  • NPI 1598100927
  Medicare reassignment NPD
• Algos Inc., a Medical Corporation

  dba Synovation Medical Group

  • Pain Medicine Physician
  • Pasadena, CA
  • NPI 1497747356

  Physical Therapist

  Medicare reassignment NPD
• Algos Inc., a Medical Corporation

  dba Synovation Medical Group

  • Pain Medicine Physician
  • Visalia, CA
  • NPI 1245832419

  Physical Therapist

  NPD
• Algos Inc., a Medical Corporation

  dba Synovation Medical Group

  • Pain Medicine Physician
  • Simi Valley, CA
  • NPI 1063890275

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1346234671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12241 INDUSTRIAL BLVD STE 210",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958301",
            "telephone_number": "800-489-6905",
            "fax_number": "626-294-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12241 INDUSTRIAL BLVD STE 210",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958301",
            "telephone_number": "800-489-6905",
            "fax_number": "626-294-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TRACI",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-01",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "22968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11470070",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "W1791415",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa O Williams, ED.S., LPC, NCC
• Sabrina Marie Williams
• Serena Williams
• Stephanie Denise Williams
• Tataneisha Williams
• Wesley Wayne Williams
• Dashonne Williamsbenjamin
• Dianne Williamson, RPH
• Heaven Willis
• Jahmaal Jason Willis, NP

• Physical Therapist in Victorville, CA
• Providers in Victorville, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.