NPIMap

Individual provider Active NPI

Nicole Marchelle Herath

  • Physician Assistant
  • Columbus, OH
National Provider Identifier
1295224350
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.005754RX Issued in OH
Practice address
55 Dillmont Dr Ste 102
Columbus, OH 43235-6458
Phone
(614) 802-6080
Fax
(380) 255-7300
NPI assigned
May 4, 2018
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.005754RX OH Primary

Addresses

Primary practice location

55 Dillmont Dr Ste 102
Columbus, OH 43235-6458

Mailing address

3525 Olentangy River Rd Ste 4330
Columbus, OH 43214-3937
Phone (614) 255-6900

Other practice location 1

3525 Olentangy River Rd Ste 4330
Columbus, OH 43214-3937
Phone (614) 255-6900

Other names 1

  • Nicole Marchelle Miller Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190522002078 OH Practitioner - Physician Assistant 9436492006 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Medical Group, LLCGroup PAC ID 7719040385, 265 clinicians
Central Ohio Hospitalists, IncGroup PAC ID 7810985686, 194 clinicians

Practice addresses (Care Compare)

2951 Maple Ave
Zanesville, OH 43701-1406
Phone (740) 454-4000

3535 Olentangy River Rd
Columbus, OH 43214-3908
Phone (614) 566-5000

945 Bethesda Dr
Zanesville, OH 43701-1880

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
82.58
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Group, LLC CurrentSince Sep 16, 2024 Accepting new patients
Ohiohealth Corporation CurrentSince Jul 1, 2019 Accepting new patients
Ohiohealth Corporation CurrentSince Jul 1, 2019 Accepting new patients

Locations

1087 Dennison Ave
Columbus, OH 43201
Phone (614) 458-9000

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

2951 Maple Ave
Zanesville, OH 43701
Phone (740) 454-4000

945 Bethesda Dr
Ste 330
Zanesville, OH 43701
Phone (740) 454-4038

Organizations & group practices 9

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1525392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1295224350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 OLENTANGY RIVER RD STE 4330",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143937",
            "telephone_number": "614-255-6900",
            "fax_number": "614-255-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 DILLMONT DR STE 102",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432356458",
            "telephone_number": "614-802-6080",
            "fax_number": "380-255-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3525 Olentangy River Rd Ste 4330",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432143937",
            "country_code": "US",
            "telephone_number": "614-255-6900",
            "fax_number": "614-255-6901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERATH",
        "first_name": "NICOLE",
        "middle_name": "MARCHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-04",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005754RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MILLER",
            "middle_name": "MARCHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.