Individual provider Active NPI

Willie Cromer, PTA

  • Physical Therapy Assistant
  • Riverside, CA
National Provider Identifier
1780473926
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
8687 Issued in CA
Practice address
8175 Limonite Ave Ste a
Riverside, CA 92509-6120
Phone
(951) 370-7033
Fax
(951) 370-7034
NPI assigned
May 5, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 8687 CA Primary

Addresses

Primary practice location

8175 Limonite Ave Ste a
Riverside, CA 92509-6120

Mailing address

8175 Limonite Ave Ste a
Riverside, CA 92509-6120
Phone (951) 370-7033

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

State licenses

LicenseStateTypeSpecialty
8687CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1780473926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 LIMONITE AVE STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925096120",
            "telephone_number": "951-370-7033",
            "fax_number": "951-370-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8175 LIMONITE AVE STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925096120",
            "telephone_number": "951-370-7033",
            "fax_number": "951-370-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROMER",
        "first_name": "WILLIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "8687",
            "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 May 5, 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.