Individual provider Active NPI

Melissa Renee Nickols, PA-C

  • Physician Assistant
  • Columbia, MD
National Provider Identifier
1396238499
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0007235 Issued in MD
Practice address
7120 Minstrel Way Ste 100
Columbia, MD 21045-5274
Phone
(410) 290-6677
NPI assigned
Jun 13, 2018
Last updated
Mar 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 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 C0007235 MD Primary

Addresses

Primary practice location

7120 Minstrel Way Ste 100
Columbia, MD 21045-5274

Mailing address

7120 Minstrel Way Ste 100
Columbia, MD 21045-5274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC, MD3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20191217001744 VA Practitioner - Physician Assistant 2860749694 Reassigns benefits to 2 organizations
I20200127001437 DC Practitioner - Physician Assistant 2860749694 Reassigns benefits to 3 organizations
I20260420001218 MD Practitioner - Physician Assistant 2860749694 Reassigns benefits to 1 organization

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
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians
Gastro Center of Maryland LLCGroup PAC ID 7517972037, 23 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307

3405 Olandwood CT
Suite 102
Olney, MD 20832-1447
Phone (301) 570-8671

7120 Minstrel Way
Suite 100
Columbia, MD 21045-5274
Phone (410) 290-6677

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.52 of 100Reported as group
Quality
56.13
Promoting interoperability
98
Improvement activities
40
Cost
80.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0007235MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gastro Center of Maryland LLC CurrentSince Feb 1, 2026 Accepting new patients
Inova Health Care Services CurrentSince Jan 6, 2025 Accepting new patients
Inova Health Care Services CurrentSince Jan 6, 2025 Accepting new patients
Inova Health Care Services CurrentSince Jan 6, 2025 Accepting new patients
Arundel Anesthesia, LLC PastSince Nov 27, 2022 Accepting new patients
Old Dominion Anesthesia LLC Past Accepting new patients

Locations

7120 Minstrel Way
Ste 100
Columbia, MD 21045
Phone (571) 210-4828

3405 Olandwood Ct
Ste 102
Olney, MD 20832
Phone (301) 570-8671

3022 Williams Dr
Ste 301
Fairfax, VA 22031
Phone (703) 698-1775

3700 Joseph Siewick Dr
Ste 308
Fairfax, VA 22033
Phone (703) 716-8700

8095 Innovation Park Dr
Bldg C
Fairfax, VA 22031
Phone (571) 472-6253

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

Organizations & group practices 7

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 2

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": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1396238499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 MINSTREL WAY STE 100",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 MINSTREL WAY STE 100",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455274",
            "telephone_number": "410-290-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKOLS",
        "first_name": "MELISSA",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0007235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.