Individual provider Active NPI

Coral Molina, DO

  • Family Medicine Physician
  • Bolivar, MO
National Provider Identifier
1407433360
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2024015222 Issued in MO
Practice address
1500 N Oakland Ave
Bolivar, MO 65613-3099
Phone
(417) 326-6000
NPI assigned
Mar 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL83525 SC
Family Medicine Physician 207Q00000X 2024015222 MO Primary

Addresses

Primary practice location

1500 N Oakland Ave
Bolivar, MO 65613-3099

Mailing address

1500 N Oakland Ave
Bolivar, MO 65613-3099

Other practice location 1

853 N. Church Street
Suite 510
Spartanburg, SC 29303
Phone (864) 560-6193

Other practice location 2

7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-9597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20240710003524 MO Practitioner - Family Practice 1456752054 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL83525SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Health Physicians Family Medicine CurrentSince Jul 2, 2024 Accepting new patients
Citizens Memorial Healthcare CurrentSince Sep 1, 2025 Accepting new patients
Citizens Memorial Healthcare Family Medicine CurrentSince Sep 1, 2025 Accepting new patients

Locations

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

4407 E 50th Ter
Kansas City, MO 64130
Phone (816) 924-1201

7900 Lees Summit Rd
Kansas City, MO 64139
Phone (816) 373-4485

Organizations & group practices 3

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": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1407433360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133099",
            "telephone_number": "417-326-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "853 N. Church Street",
            "address_2": "Suite 510",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "29303",
            "country_code": "US",
            "telephone_number": "864-560-6193",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7900 Lees Summit Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641391236",
            "country_code": "US",
            "telephone_number": "816-404-9597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLINA",
        "first_name": "CORAL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL83525",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2024015222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

Verify at the official NPI Registry.