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

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Joe C Monsour

Title

Operator

Phone

(620) 365-6002

Specialties & licenses 1

Addresses

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

{
    "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 (Guest Home Estates V)

• Exclusive Provider Organization in Iola, KS
• Providers in Iola, KS by specialty
• 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.