Individual provider Active NPI

Melissa Ericksen, LMT

  • Massage Therapist
  • Saint George, UT
National Provider Identifier
1487416756
Registry record updated Jun 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
12164957-4701 Issued in UT
Practice address
1664 S Dixie Dr Ste L104
Saint George, UT 84770-7331
Phone
(435) 668-8977
NPI assigned
Jan 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2025

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 12164957-4701 UT Primary

Addresses

Primary practice location

1664 S Dixie Dr Ste L104
Saint George, UT 84770-7331

Mailing address

1664 S Dixie Dr Ste L104
Saint George, UT 84770-7331
Phone (435) 668-8977

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
12164957-4701UTMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sagebrush Massage Therapy LLC Massage Therapist CurrentSince Aug 11, 2024 Accepting new patients

Locations

1664 S Dixie Dr
Ste L104
Saint George, UT 84770
Phone (435) 668-8977

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749340800000",
    "number": "1487416756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1664 S DIXIE DR STE L104",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847707331",
            "telephone_number": "435-668-8977",
            "fax_number": "435-222-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 S DIXIE DR STE L104",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847707331",
            "telephone_number": "435-668-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSEN",
        "first_name": "MELISSA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2025-06-08",
        "certification_date": "2025-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "UT",
            "license": "12164957-4701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.