Individual provider Active NPI

Mariah Guerard, LMT

  • Massage Therapist
  • Fairbanks, AK
National Provider Identifier
1780046797
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
101380 Issued in AK
Practice address
3180 Peger Rd Ste 275
Fairbanks, AK 99709-5484
Phone
(907) 799-5071
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 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 101380 AK Primary

Addresses

Primary practice location

3180 Peger Rd Ste 275
Fairbanks, AK 99709-5484

Mailing address

4758 Glasgow Dr Apt 1
Fairbanks, AK 99709-2916
Phone (907) 799-5071

Other names 1

  • Mariah Verdugo Former name

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
101380AKMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Therapeutic Massage LLC Massage Therapist PastSince Apr 24, 2022 Accepting new patients

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1780046797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4758 GLASGOW DR APT 1",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997092916",
            "telephone_number": "907-799-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 PEGER RD STE 275",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095484",
            "telephone_number": "907-799-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERARD",
        "first_name": "MARIAH",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "101380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIAH",
            "last_name": "VERDUGO",
            "credential": "LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.