NPIMap

Organization Active NPI

Lindengrove Communities LLC

Doing business as LindenGrove Mukwonago

  • Skilled Nursing Facility
  • Mukwonago, WI
National Provider Identifier
1003998790
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
5002 Issued in WI
Legal business name
LINDENGROVE COMMUNITIES LLC
Doing business as
LindenGrove Mukwonago
Practice address
837 E Veterans Way
Mukwonago, WI 53149-1013
Phone
(262) 363-6830
Fax
(262) 363-6837
NPI assigned
Oct 20, 2006
Last updated
Jul 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Authorized official

Name
Julie Anne Marks
Title
Cfo
Phone
(920) 261-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 5002 WI Primary

Addresses

Primary practice location

837 E Veterans Way
Mukwonago, WI 53149-1013

Mailing address

1045 Hill St
Watertown, WI 53098-3015
Phone (920) 261-0400

Other identifiers 2

IdentifierTypeStateIssuer
100244176MedicaidWI
20182200MedicaidWI

Other names 1

  • LindenGrove Mukwonago Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230803001405 WI Part A Provider - Skilled Nursing Facility 0749641058 Practice locations: Mukwonago, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003998790. Details of each certification follow.

Skilled nursing facility certification: CCN 525645

Legal name
LINDENGROVE COMMUNITIES LLC
Doing business as
LINDENGROVE MUKWONAGO
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 15, 1998
Last certification
Jul 24, 2024
Beds
47
Ownership / control type
Nonprofit Corporation
Multi-facility organization
ILLUMINUS
Organization structure
LLCNon-profit
Incorporated
Jan 16, 2023 in WI
Enrollment address
837 E Veterans Way
Mukwonago, WI 53149-1013
Nursing home name
LINDENGROVE MUKWONAGO

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lindengrove MukwonagoCCN 525645 · All quality measures
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Oct 15, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4740.8 residents per day on average
Penalties (3 years)
1Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Lindengrove Communities LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

18650 W Corporate Dr
Ste 303
Brookfield, WI 53045

837 E Veterans Way
Mukwonago, WI 53149
Phone (262) 363-6830

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Matthew R Mauthe Individual Corporate OfficerCeo Mar 20, 2023 100%
Operational/Managerial ControlCeo Mar 20, 2023
Adp of the SNF Mar 20, 2023
Todd Fischer Individual Corporate DirectorBoard Chair Mar 7, 2023
Managing Control - Governing BodyManager Mar 7, 2023
Illuminus Inc Organization, Watertown, WI Management services company, Non-profit Operational/Managerial Control Mar 20, 2023 100%
Adp of the SNF Jul 11, 2025
Scott Dettman Individual Corporate DirectorSecretary/Treasurer Mar 7, 2023
The Hills at Cortland Ridge, Inc. Organization, Watertown, WI Corporation, Holding company, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 14, 2023 100%
Kevin Kohlhoff Individual Corporate DirectorDirector Mar 7, 2023
Robert Meidenbauer Individual Corporate DirectorVice Chair Mar 7, 2023
Katie Van Der Linden Individual Corporate DirectorDirector Mar 7, 2023
Marquardt Village Inc Organization, Watertown, WI Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Mar 7, 2023 100%
Dennis Konkol Individual Corporate DirectorDirector Oct 1, 2024
Steven Heroux Individual Corporate DirectorDirector Aug 1, 2024
Lynne Wagner Individual Corporate DirectorDirector Oct 1, 2024
Steven J Kim Individual Operational/Managerial Control Apr 10, 2017
Adp of the SNF Apr 10, 2017
Julie Marks Individual Corporate OfficerCfo Jun 5, 2025
Corporate DirectorBoard Member Aug 18, 2025
Operational/Managerial Control Jun 5, 2025
Adp of the SNF Jun 5, 2025
Suzanne Whitty Individual Operational/Managerial Control Apr 10, 2017
Adp of the SNF Apr 28, 2025

Owners & managing parties with NPI records 1

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

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1003998790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 HILL ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983015",
            "telephone_number": "920-261-0400",
            "fax_number": "920-261-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 E VETERANS WAY",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531491013",
            "telephone_number": "262-363-6830",
            "fax_number": "262-363-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDENGROVE COMMUNITIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-261-0400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "5002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100244176",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20182200",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "LindenGrove Mukwonago",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mukwonago, WI

Sources for this page

Verify at the official NPI Registry.