Active NPI
John Raymond Marnocha, MD
- Dermatology Physician
- Bonita Springs, FL
National Provider Identifier
1225369630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 14116-20
- Practice address
- 3330 Crossings CT
PH2
Bonita Springs, FL 34134-2686 - Phone
- (239) 948-9446
- Fax
- (239) 948-9446
- NPI assigned
- Jan 25, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 14116-20 | WI | Primary |
Addresses
Primary practice location
3330 Crossings CT
PH2
Bonita Springs, FL 34134-2686
Mailing address
3330 Crossings CT
PH2
Bonita Springs, FL 34134-2686
Phone (239) 948-9446
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14116-20 | WI | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264377600000",
"number": "1225369630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3330 CROSSINGS CT",
"address_2": "PH2",
"city": "BONITA SPRINGS",
"state": "FL",
"postal_code": "341342686",
"telephone_number": "239-948-9446",
"fax_number": "239-948-9446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3330 CROSSINGS CT",
"address_2": "PH2",
"city": "BONITA SPRINGS",
"state": "FL",
"postal_code": "341342686",
"telephone_number": "239-948-9446",
"fax_number": "239-948-9446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARNOCHA",
"first_name": "JOHN",
"middle_name": "RAYMOND",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-25",
"last_updated": "2010-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WI",
"license": "14116-20",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonita Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.