Individual provider Active NPI

Melissa Tullock, DO

  • Pediatrics Physician
  • Columbus, OH
National Provider Identifier
1144615428
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34.014527 Issued in OH
Practice address
700 Childrens Dr
Columbus, OH 43205-2664
Phone
(614) 722-2000
NPI assigned
Apr 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X 34.014527 OH
Hospitalist Physician 208M00000X 34.014527 OH
Pediatrics Physician 208000000X 34.014527 OH Primary

Addresses

Primary practice location

700 Childrens Dr
Columbus, OH 43205-2664

Mailing address

700 Childrens Dr
Columbus, OH 43205-2639
Phone (614) 722-2000

Other practice location 1

444 Butterly Gardens Drive
Columbus, OH 43215
Phone (614) 722-2000

Other identifiers 1

IdentifierTypeStateIssuer
0403319MedicaidOH

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
I20200630000755 OH Practitioner - HospitalistPractitioner - Pediatric Medicine 6406102219 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Pediatric Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Academic Association, Inc.Group PAC ID 2961306774, 252 clinicians

Practice addresses (Care Compare)

700 Children'S Dr
Columbus, OH 43205-2664
Phone (614) 722-4579

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Academic Association, Inc. Pediatrics CurrentSince Aug 17, 2020 Accepting new patients
Nationwide Children'S Hospital CurrentSince Sep 2, 2024 Accepting new patients
Nationwide Children'S Hospital Pediatrics CurrentSince Sep 2, 2024 Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients

Locations

Dept 781629
Detroit, MI 48278

444 Butterfly Gardens Dr
Columbus, OH 43215
Phone (614) 938-0167

Dept L289
Columbus, OH 43260

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

Organizations & group practices 4

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": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1144615428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052639",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 Butterly Gardens Drive",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "43215",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TULLOCK",
        "first_name": "MELISSA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "OH",
            "license": "34.014527",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "34.014527",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34.014527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0403319",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.