Erin R Tilly, RMT, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

104002 Issued in AK

Practice address

455 3Rd Ave
Fairbanks, AK 99701-4737

Phone

(907) 888-2344

Fax

(907) 451-6699

NPI assigned

Nov 4, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1447623012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3842 HARDLUCK DR",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095976",
            "telephone_number": "907-888-2344",
            "fax_number": "907-451-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 3RD AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014737",
            "telephone_number": "907-888-2344",
            "fax_number": "907-451-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLY",
        "first_name": "ERIN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "RMT, LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "ZZ",
            "license": "006369",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "104002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louise Thurmond
• Roger Dean Thurmond, M.D.,P.C.
• Madalyn Ticknor
• Brock Fred Tidstrom, DDS
• Amond Tilley
• Tiffany Rae Timm, PTA
• Caroline Elizabeth Timmerman, MD
• Sean Michael Timmons, PA-C
• Timothy J Woller D.D.S. PC
• Timothy W Teslow, M.D., P.C.

• Massage Therapist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.