Karin Johana Bock Mullooly

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Practice address

1090 Hay Row Rd
Lake Wylie, SC 29710-9629

Phone

(516) 316-9959

NPI assigned

Oct 4, 2022

Last updated

Oct 4, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1306561212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 HIGHWAY 274 # 134",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297106045",
            "telephone_number": "803-631-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 HAY ROW RD",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297109629",
            "telephone_number": "516-316-9959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCK MULLOOLY",
        "first_name": "KARIN",
        "middle_name": "JOHANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health & Wellness Coach in Lake Wylie, SC
• Providers in Lake Wylie, SC by specialty
• Health & Wellness Coach in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.