Timberline Sports Massage LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

TIMBERLINE SPORTS MASSAGE LLC

Practice address

5107 W Overland Rd Ste C
Boise, ID 83705-5189

Phone

(208) 918-4458

NPI assigned

Aug 19, 2026

Organization subpart

No

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

Authorized official

Name

Emily Mathis, LMT, FRCMS, MFDC

Title

Owner/Manager

Phone

(208) 918-4458

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrea Baird

  • Massage Therapist
  • Boise, ID
  • NPI 1346042777
  NPD (past)
• Michael William Murray

  • Massage Therapist
  • Boise, ID
  • NPI 1386430262
  NPD (past)
• Dylan Anthony Wayman, LMT, CPT, NMT

  • Massage Therapist
  • Boise, ID
  • NPI 1366358285
  NPD (past)

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

{
    "created_epoch": "1787097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787097600000",
    "number": "1407762719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5107 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837055216",
            "telephone_number": "208-918-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5107 W OVERLAND RD STE C",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837055189",
            "telephone_number": "208-918-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMBERLINE SPORTS MASSAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-19",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "208-918-4458",
        "authorized_official_credential": "LMT, FRCMS, MFDC"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mildred Ann Tikker, LCSW
• Suzanna Marie Tillotson, PH.D.
• Kelli Tillquist, PSYD
• Daniel Edward Timberlake, PHD
• Timberline Medical Consultants LLC
• Times Square Dental
• Times Square Dental
• Nicole Timme, RD
• Kevin Timmel, MD
• Timothy C. Paventy DMD, LLC

• Massage Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Massage Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; 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.