Individual provider Active NPI

Marisa Miller, APRN-CNP

  • Family Nurse Practitioner
  • Canal Winchester, OH
National Provider Identifier
1275335028
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0039564 Issued in OH
Practice address
3620 Gender Rd
Canal Winchester, OH 43110-8679
Phone
(614) 829-3015
NPI assigned
Mar 25, 2025
Last updated
Jul 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0039564 OH Primary

Addresses

Primary practice location

3620 Gender Rd
Canal Winchester, OH 43110-8679

Mailing address

5084 Stoneybrook Blvd
Hilliard, OH 43026-9366
Phone (740) 816-9295

Other practice location 1

1600 Cross Creeks Blvd
Pickerington, OH 43147-8189
Phone (614) 626-0157

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
0039564OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Urgent Care, LLC. CurrentSince Aug 17, 2025 Accepting new patients
Superior Urgent Care, LLC. CurrentSince Aug 17, 2025 Accepting new patients

Locations

3620 Gender Rd
Canal Wnchstr, OH 43110
Phone (614) 202-0310

1600 Cross Creeks Blvd
Pickerington, OH 43147
Phone (614) 626-0157

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25285/brand/1/csg/1/fhir/r4
  • Direct secure messaging: marisa.miller.1@25285.direct.athenahealth.com

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": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1275335028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5084 STONEYBROOK BLVD",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430269366",
            "telephone_number": "740-816-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 GENDER RD",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431108679",
            "telephone_number": "614-829-3015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Cross Creeks Blvd",
            "address_purpose": "LOCATION",
            "city": "Pickerington",
            "state": "OH",
            "postal_code": "431478189",
            "country_code": "US",
            "telephone_number": "614-626-0157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARISA",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0039564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canal Winchester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.