Koa Community Clinic, Inc

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

KOA COMMUNITY CLINIC, INC

Practice address

75-5995 Kuakini Hwy Ste 213
Kailua Kona, HI 96740-2120

Phone

(808) 638-3343

Fax

(844) 308-3545

NPI assigned

Apr 13, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Corinne Maul de SotoNPI 1841603651

Title

Executive Director

Phone

(808) 638-3343

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Corinne Maul de Soto, ND

  • Naturopath
  • Kailua Kona, HI
  • NPI 1841603651
  NPD Authorized official

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1952920555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5995 KUAKINI HWY STE 213",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402120",
            "telephone_number": "808-638-3343",
            "fax_number": "844-308-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5995 KUAKINI HWY STE 213",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402120",
            "telephone_number": "808-638-3343",
            "fax_number": "844-308-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOA COMMUNITY CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-13",
        "last_updated": "2024-07-03",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "MAUL DE SOTO",
        "authorized_official_first_name": "CORINNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "808-638-3343",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Knezek May, PSYCHD
• Amy Emily Knights
• Susan Marie Knutowicz, LMT
• Tomi Knutson, LMT
• Koa Clinic, Inc
• Natasha Kobayashi, PA
• Koch Kounseling LLC
• Tiffany Leigh Koch, LMFT
• Dawn L Koehler, LSW
• Stefan Dillon Koehler, RN

• Community Health Clinic/Center in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Community Health Clinic/Center in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.