Shawano Health Services LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3175 Issued in WI

Legal business name

SHAWANO HEALTH SERVICES LLC

Practice address

1436 S Lincoln St
Shawano, WI 54166-3427

Phone

(715) 526-6111

Fax

(715) 524-5708

NPI assigned

Sep 24, 2015

Organization subpart

No

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

Authorized official

Name

Jeffrey Charles Hoehn

Title

Member Manager

Phone

(636) 698-8600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013386614. Details of each certification follow.

• CCN 525335 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 525335

Legal name

SHAWANO HEALTH SERVICES LLC

Doing business as

SHAWANO HEALTH SERVICES

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 29, 1983

Last certification

Feb 5, 2025

Beds

100

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Northshore Healthcare

Organization structure

LLCProprietary

Enrollment address

1436 S Lincoln St
Shawano, WI 54166-3427

Nursing home name

SHAWANO HEALTH SERVICES

Affiliated entity

NORTH SHORE HEALTHCARE

Listed as

Shawano Health ServicesCCN 525335 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

3 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Mar 29, 1983

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10044.6 residents per day on average

Chain

North Shore Healthcare59 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 5

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

Owners & managing parties with NPI records 1

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

• James Bruno, DO

  • Internal Medicine Physician
  • Green Bay, WI
  • NPI 1578973087

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 6

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.

• Patricia R Ainsworth, PT

  • Physical Therapist
  • Shawano, WI
  • NPI 1790945863
  NPD (past)
• Erin Grosskopf, PTA

  • Physical Therapy Assistant
  • Wittenberg, WI
  • NPI 1164697843
  NPD (past)
• Carrie Hostettler, COTA

  • Occupational Therapy Assistant
  • New London, WI
  • NPI 1598912404
  NPD (past)
• Corrina Jolinda Tuma, PTA

  • Physical Therapy Assistant
  • Shawano, WI
  • NPI 1174783245
  NPD (past)
• Lisa Jane Vanderzanden, OTR

  • Occupational Therapist
  • Germantown, WI
  • NPI 1205341294
  NPD (past)
• Sara Mallams, MS OTR/L

  • Occupational Therapist
  • Indianapolis, IN
  • NPI 1285022046
  NPD (past)

Affiliated clinicians 2

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

• James Bruno, DO

  • Internal Medicine Physician
  • Green Bay, WI
  • NPI 1578973087

  Nursing home

  Care Compare affiliation
• Madhavi Reddy Cherukula, MD

  • Internal Medicine Physician
  • Appleton, WI
  • NPI 1265847396

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443052800000",
    "number": "1013386614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5536 N KENT AVE",
            "city": "WHITEFISH BAY",
            "state": "WI",
            "postal_code": "532175155",
            "telephone_number": "636-698-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 S LINCOLN ST",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541663427",
            "telephone_number": "715-526-6111",
            "fax_number": "715-524-5708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWANO HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-24",
        "last_updated": "2015-09-24",
        "status": "A",
        "authorized_official_last_name": "HOEHN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "636-698-8600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawano Clinic, Inc (ThedaCare Physicians Shawano)
• Shawano County Department of Community Program
• Shawano County Department of Human Services
• Shawano County Dept. of Social Services
• Shawano Family Dentistry
• Shawano Place
• Shawano-Gresham School District
• Kevin Daniel Sheier, MS, LPC
• Heather Beverly Sheski
• Shopko Stores Operating Co., LLC (Shopko Pharmacy 2215)

• Skilled Nursing Facility in Shawano, WI
• Providers in Shawano, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.