Individual provider Active NPI

Michelle Clarice Golla, MD

  • Pediatrics Physician
  • Reynoldsburg, OH
National Provider Identifier
1043535586
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.099603 Issued in OH
Practice address
8050 E Main St Ste 3200
Reynoldsburg, OH 43068-2819
Phone
(614) 434-5437
Fax
(614) 434-5438
NPI assigned
Mar 27, 2010
Last updated
Jun 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.099603 OH Primary

Addresses

Primary practice location

8050 E Main St Ste 3200
Reynoldsburg, OH 43068-2819

Mailing address

8050 E Main St Ste 3200
Reynoldsburg, OH 43068-2819
Phone (614) 434-5437

Other identifiers 1

IdentifierTypeStateIssuer
0087407MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190618001916 OH Practitioner - Pediatric Medicine 0143553537 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35099603OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients

Locations

655 Africa Rd
Westerville, OH 43082

Interoperability endpoints

  • Direct secure messaging: mgolla19125@copcp.medicity.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1269648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1043535586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8050 E MAIN ST STE 3200",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430682819",
            "telephone_number": "614-434-5437",
            "fax_number": "614-434-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8050 E MAIN ST STE 3200",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430682819",
            "telephone_number": "614-434-5437",
            "fax_number": "614-434-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLA",
        "first_name": "MICHELLE",
        "middle_name": "CLARICE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-27",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.099603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0087407",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reynoldsburg, OH

Sources for this page

Verify at the official NPI Registry.