Marnichelle Ky Bonocan Clamohoy, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

255300 Issued in TN

Practice address

102 N Broadway St
Johnson City, TN 37601-3525

Phone

(423) 588-9978

Fax

(423) 722-3401

NPI assigned

Oct 14, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Marnichelle Ky Bonocan Clamohoy Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Dragonfly Medical and Behavioral Health Professsional Corporation

  • Addiction Medicine (Family Medicine) Physician
  • Johnson City, TN
  • NPI 1689134231
  NPD
• Dragfonfly Wellness Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Johnson City, TN
  • NPI 1134689730
  NPD (past)

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1215690441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 E OAKLAND AVE APT 4",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013469",
            "telephone_number": "423-676-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N BROADWAY ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013525",
            "telephone_number": "423-588-9978",
            "fax_number": "423-722-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAMOHOY",
        "first_name": "MARNICHELLE KY",
        "middle_name": "BONOCAN",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "255300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARNICHELLE KY",
            "last_name": "CLAMOHOY",
            "middle_name": "BONOCAN",
            "prefix": "MS.",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Zinnia Cielo, PT
• Haley N Cigarroa, LPC/ MHSP
• Justin David Ciralsky, BA
• Circe Medical Services LLC
• Vanessa Civil-Smith, LPC-MHSP
• Ashby Paige Clanton, DDS
• Angel Shannon Clark, MA
• Bendik Clark, M.D.
• Hunter Kelsey Clark
• Jason Clark, OTR/L

• Registered Nurse in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; 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.