Organization Active NPI

Koloa DPC LLC

  • Internal Medicine Physician
  • Koloa, HI
National Provider Identifier
1538072814
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
KOLOA DPC LLC
Practice address
5460 Koloa Rd Ste G2O2
Koloa, HI 96756-9421
Phone
(802) 355-7479
NPI assigned
Sep 25, 2026
Last updated
Sep 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Authorized official

Name
Molly Rebecca Heublein, MDNPI 1720211279
Title
MD
Phone
(802) 355-7479

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

5460 Koloa Rd Ste G2O2
Koloa, HI 96756-9421

Mailing address

PO Box 1887
Koloa, HI 96756-1887
Phone (802) 355-7479

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1790294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790294400000",
    "number": "1538072814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1887",
            "city": "KOLOA",
            "state": "HI",
            "postal_code": "967561887",
            "telephone_number": "802-355-7479",
            "fax_number": "808-309-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 KOLOA RD STE G2O2",
            "city": "KOLOA",
            "state": "HI",
            "postal_code": "967569421",
            "telephone_number": "802-355-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOLOA DPC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-25",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A",
        "authorized_official_last_name": "HEUBLEIN",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "REBECCA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "802-355-7479",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Koloa, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.