Organization Active NPI

Fellowship Assisted Living LLC

  • Long-Term Care Clinical Nurse Specialist
  • Plano, TX
National Provider Identifier
1760339717
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long-Term Care Clinical Nurse SpecialistTaxonomy code 364SL0600X
Legal business name
FELLOWSHIP ASSISTED LIVING LLC
Practice address
2345 Monticello Cir
Plano, TX 75075-6678
Phone
(214) 407-1326
NPI assigned
Mar 10, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Authorized official

Name
Johanna Kikontwe, RDH
Title
Manager
Phone
(314) 420-2928

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long-Term Care Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SL0600X Primary

Addresses

Primary practice location

2345 Monticello Cir
Plano, TX 75075-6678

Mailing address

2345 Monticello Cir
Plano, TX 75075-6678
Phone (214) 407-1326

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1773100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773100800000",
    "number": "1760339717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 MONTICELLO CIR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750756678",
            "telephone_number": "214-407-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 MONTICELLO CIR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750756678",
            "telephone_number": "214-407-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FELLOWSHIP ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-10",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A",
        "authorized_official_last_name": "KIKONTWE",
        "authorized_official_first_name": "JOHANNA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "314-420-2928",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "364SL0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Long-Term Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; 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.