NPIMap

Organization Active NPI

County of Sheboygan

  • Skilled Nursing Facility
  • Plymouth, WI
National Provider Identifier
1003988049
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2362 Issued in WI
Legal business name
COUNTY OF SHEBOYGAN
Practice address
N7135 Rocky Knoll Pkwy
Plymouth, WI 53073-3103
Phone
(920) 467-6464
Fax
(920) 893-0500
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Authorized official

Name
Mr. Michael J Taubenheim, N.H.A.
Title
Administrator
Phone
(920) 893-9205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2362 WI Primary

Addresses

Primary practice location

N7135 Rocky Knoll Pkwy
Plymouth, WI 53073-3103

Mailing address

N7135 Rocky Knoll Pkwy
Plymouth, WI 53073-3103
Phone (920) 467-6464

Other identifiers 3

IdentifierTypeStateIssuer
41666800MedicaidWI
32670800OtherWIPHYSICIAN MEDICAID
20141300MedicaidWI

Other names 1

  • Rocky Knoll Health Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070524000558 WI Part A Provider - Skilled Nursing Facility 2567568918 Practice locations: Plymouth, WI

Skilled nursing facility certification: CCN 525337

Legal name
COUNTY OF SHEBOYGAN
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 18, 1983
Last certification
Mar 6, 2025
Beds
149
Ownership / control type
County
Organization structure
GovernmentNon-profit
Enrollment address
N7135 Rocky Knoll Pkwy
Plymouth, WI 53073-3103
Nursing home name
ROCKY KNOLL HEALTH CARE

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Rocky Knoll Health CareCCN 525337
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Government - County
Certified
Aug 18, 1983
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
149140.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Sheboygan County Human13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

615 N 6th St
Sheboygan, WI 53081
Phone (810) 355-6178

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Katherine Clinton Individual Operational/Managerial Control Sep 11, 2017
Adp of the SNF Sep 11, 2017
Amanda Joy Kohal Individual Operational/Managerial Control May 31, 2022
Adp of the SNF May 31, 2022
Individual Adp of the SNF Oct 23, 2023
County of Sheboygan Organization, Plymouth, WI Non-profit 5% Or Greater Direct Ownership Interest Aug 18, 1983 100%
Operational/Managerial Control Aug 18, 1983
Michael Roy Lunde Individual Operational/Managerial Control Jan 1, 2020
Adp of the SNF Jan 1, 2020
Wipfli LLP Organization, Milwaukee, WI Consulting firm Operational/Managerial Control Feb 3, 1998
Adp of the SNF Nov 6, 2025
Healthpro Heritage LLC Organization, Baltimore, MD Medical provider/supplier Operational/Managerial Control Jan 1, 2025
Trustee of the SNF Jan 1, 2025
Adp of the SNF Dec 4, 2025
Alayne Krause Individual Operational/Managerial Control Feb 22, 2023
Optum 360 Services, Inc Organization, Minnetonka, MN Medical provider/supplier Operational/Managerial Control Jun 1, 2023
Adp of the SNF Dec 22, 2025
Individual Adp of the SNF Oct 23, 2024
Jeremy Fetterer Individual Operational/Managerial ControlDeputy Finance Director Sep 4, 2007
Adp of the SNF Sep 4, 2007
Cortney Loeffler Individual Operational/Managerial Control Oct 18, 2021
Adp of the SNF Oct 18, 2021

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 71

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 71

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202342400000",
    "number": "1003988049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N7135 ROCKY KNOLL PKWY",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530733103",
            "telephone_number": "920-467-6464",
            "fax_number": "920-893-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N7135 ROCKY KNOLL PKWY",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530733103",
            "telephone_number": "920-467-6464",
            "fax_number": "920-893-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SHEBOYGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-02-07",
        "status": "A",
        "authorized_official_last_name": "TAUBENHEIM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "920-893-9205",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "N.H.A."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41666800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN MEDICAID",
            "identifier": "32670800",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20141300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rocky Knoll Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plymouth, WI

Sources for this page

Verify at the official NPI Registry.