Fountain Villa Residential Care

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

N001-006 Issued in KS

Legal business name

FOUNTAIN VILLA RESIDENTIAL CARE

Practice address

2620 N Kentucky St
Iola, KS 66749-1940

Phone

(620) 365-6002

Fax

(620) 365-3510

NPI assigned

Feb 8, 2007

Organization subpart

No

Name

Mr. Joe C Monsour

Title

Operator

Phone

(620) 365-6002

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740320548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 N KENTUCKY ST",
            "city": "IOLA",
            "state": "KS",
            "postal_code": "667491940",
            "telephone_number": "620-365-6002",
            "fax_number": "620-365-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N KENTUCKY ST",
            "city": "IOLA",
            "state": "KS",
            "postal_code": "667491940",
            "telephone_number": "620-365-6002",
            "fax_number": "620-365-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN VILLA RESIDENTIAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MONSOUR",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OPERATOR",
        "authorized_official_telephone_number": "620-365-6002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "KS",
            "license": "N001-006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ensminger
• Exclusive Living Resources Inc.
• Family Physicians P a
• Nathan A Fawson, LMLP
• Scott Joseph Fehr
• Rebecca A French, ARNP-C
• Brittany Michelle Frishman, RN, IBCLC
• Yang Gong X, D. AC
• Joyce Jinelle Gonzales, APRN
• Guest Home Estate of Iola, LLC

• All providers in Iola, KS
• Exclusive Provider Organization in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.