Individual provider Active NPI

Ruth Tillman, RMP

  • Massage Therapist
  • Hagerstown, MD
National Provider Identifier
1073159778
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
R01430 Issued in MD
Practice address
12814 Shank Farm Way Ste D
Hagerstown, MD 21742-2949
Phone
(540) 435-7148
NPI assigned
Nov 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X R01430 MD Primary

Addresses

Primary practice location

12814 Shank Farm Way Ste D
Hagerstown, MD 21742-2949

Mailing address

12814 Shank Farm Way Ste D
Hagerstown, MD 21742-2949
Phone (540) 435-7148

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL email

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
R01430MDMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1073159778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12814 SHANK FARM WAY STE D",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217422949",
            "telephone_number": "540-435-7148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12814 SHANK FARM WAY STE D",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217422949",
            "telephone_number": "540-435-7148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "RUTH",
        "credential": "RMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MD",
            "license": "R01430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "email",
            "affiliation": "N",
            "address_1": "12814 Shank Farm Way Ste D",
            "city": "Hagerstown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217422949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.