Active NPI
Kimberly Van Mourik, RN, NBC-HWC
- Health & Wellness Coach
- Danvers, MA
National Provider Identifier
1790679868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- Practice address
- 122 Locust St
Danvers, MA 01923-1671 - Phone
- (339) 234-2869
- NPI assigned
- Jun 4, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN2286222 | MA | |
| Health & Wellness Coach | 171400000X | Primary |
Addresses
Primary practice location
122 Locust St
Danvers, MA 01923-1671
Mailing address
122 Locust St
Danvers, MA 01923-1671
Phone (339) 234-2869
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2286222 | MA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748995200000",
"number": "1790679868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 LOCUST ST",
"city": "DANVERS",
"state": "MA",
"postal_code": "019231671",
"telephone_number": "339-234-2869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 LOCUST ST",
"city": "DANVERS",
"state": "MA",
"postal_code": "019231671",
"telephone_number": "339-234-2869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN MOURIK",
"first_name": "KIMBERLY",
"credential": "RN, NBC-HWC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-06-04",
"last_updated": "2025-06-04",
"certification_date": "2025-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "RN2286222",
"primary": false
},
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danvers, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.