Active NPI
American Lutheran Homes, Inc.
- Skilled Nursing Facility
- Mondovi, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 3223
- Legal business name
- AMERICAN LUTHERAN HOMES, INC.
- Practice address
- 200 Memorial Dr
Mondovi, WI 54755-1325 - Phone
- (715) 926-4962
- Fax
- (715) 926-3933
- NPI assigned
- Jun 9, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amy Duhr
- Title
- Ceo
- Phone
- (715) 832-3003
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 3223 | WI | Primary |
Addresses
Primary practice location
200 Memorial Dr
Mondovi, WI 54755-1325
Mailing address
822 Porter Ave
Eau Claire, WI 54701-3813
Phone (715) 832-3007
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20179700 | Medicaid | WI |
Other names 1
- American Lutheran Homes - Mondovi
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071008000068 | WI | Part A Provider - Skilled Nursing Facility | 5799696654 | Practice locations: Mondovi, WI |
Skilled nursing facility certification: CCN 525383
- Legal name
- AMERICAN LUTHERAN HOMES, INC.
- Doing business as
- AMERICAN LUTHERAN HOMES - MONDOVI
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 1985
- Last certification
- Mar 12, 2025
- Beds
- 35
- Ownership / control type
- Church Related
- Multi-facility organization
- American Lutheran Homes, Inc
- Organization structure
- Corporation
- Incorporated
- Jun 9, 1961 in WI
- Enrollment address
- 200 Memorial Drive
Mondovi, WI 54755 - Nursing home name
- AMERICAN LUTHERAN HOME-MONDOVI
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
- American Lutheran Home-Mondovi
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Church related
- Certified
- Apr 1, 1985
- Medicare certification status
- Active
- Certified beds
- 35
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0674269 | American Lutheran Homes Inc | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- American Lutheran Homes - Menomonie
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Menomonie, WI
- NPI 1124068689
Ownership & related parties
All disclosed owners & managing parties 20
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Stephany Grossier | Corporate Director | May 30, 2024 | |
| Adp of the SNF | Mar 18, 2025 | ||
| Tonya Lisowski | Operational/Managerial Control | Jul 12, 2016 | |
| Adp of the SNF | Jul 12, 2016 | ||
| Adp of the SNF | Jan 1, 2023 | ||
| Linda Larson | Corporate Director | Jan 28, 2025 | |
| Chelsea Tande | Operational/Managerial Control | Apr 26, 2022 | |
| Adp of the SNF | Apr 1, 2025 | ||
| Adp of the SNF | Mar 18, 2025 | ||
| Anita Reid | Corporate Director | May 30, 2023 | |
| Jenny Lilyquist | Operational/Managerial Control | Jan 26, 2017 | |
| Adp of the SNF | Jan 26, 2017 | ||
| Adp of the SNF | Jan 1, 2023 | ||
| Trevor Rich | Operational/Managerial Control | Dec 26, 2024 | |
| Adp of the SNF | Dec 26, 2024 | ||
| Amy K Duhr | Corporate Officer | Jan 17, 2020 | |
| Operational/Managerial Control | Jan 17, 2020 | ||
| Adp of the SNF | Jan 17, 2020 | ||
| Joanne Erickson | Corporate Director | May 30, 2023 | |
| Jamie Larson | Corporate Officer | Aug 24, 2021 | |
| Operational/Managerial Control | Aug 24, 2021 | ||
| Adp of the SNF | Aug 24, 2021 | ||
| David Larson | Corporate Director | May 30, 2021 | |
| Rita Lee | Corporate Director | May 30, 2018 | |
| Grace Lutheran Foundation, Inc. | Operational/Managerial Control | Jan 1, 2000 | |
| Adp of the SNF | Mar 4, 2025 | ||
| Kevin Hungerford | Operational/Managerial Control | Jun 1, 2025 | |
| Matthew P Berg | Adp of the SNF | Jul 1, 2016 |
Owners & managing parties with NPI records 3
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Physical Therapist
- Altoona, WI
- NPI 1639960347
Adp of the SNF, Operational/Managerial Control
-
- Skilled Nursing Facility
- Altoona, WI
- NPI 1952756991
Adp of the SNF, Operational/Managerial Control
-
- Family Medicine Physician
- Eau Claire, WI
- NPI 1922531433
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Menomonie, WI
- NPI 1124068689
Grace Lutheran Foundation, Inc.
Practitioners & affiliated clinicians
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": "1149811200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1675209600000",
"number": "1215978697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "822 PORTER AVE",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547013813",
"telephone_number": "715-832-3007",
"fax_number": "715-832-3737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MEMORIAL DR",
"city": "MONDOVI",
"state": "WI",
"postal_code": "547551325",
"telephone_number": "715-926-4962",
"fax_number": "715-926-3933"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMERICAN LUTHERAN HOMES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-09",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A",
"authorized_official_last_name": "DUHR",
"authorized_official_first_name": "AMY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "715-832-3003"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WI",
"license": "3223",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20179700",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "American Lutheran Homes - Mondovi",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Mondovi, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.