Bethany-St Joseph Corporation
Organization Active NPI Skilled Nursing Facility · La Crosse, WI
NPI 1356334205 · NPPES record last updated Dec 6, 2024
Key facts
- NPI
- 1356334205
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 2540 (WI)
- Legal business name
- BETHANY-ST JOSEPH CORPORATION
- Practice address
- 2501 Shelby Rd
La Crosse, WI 54601-8037 - Phone
- (608) 788-5700
- Fax
- (608) 788-4030
- NPI assigned
- Aug 25, 2005
- Organization subpart
- No
Authorized official
- Name
- Kimberly Gochanour
- Title
- Ceo
- Phone
- (608) 788-5700
Owners & managing parties with NPI records 1
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 5
Facilities with the same owner 65
Affiliated clinicians 2
-
Mary Bassing, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Bethany St Joseph Care Ctr
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★★★★ 5 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jan 17, 1977
- Medicare certification status
- Active
- Certified beds
- 100 · 71.3 residents per day on average
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Skilled nursing facility certification: CCN 525265
- Legal name
- BETHANY-ST JOSEPH CORPORATION
- Doing business as
- BETHANY ST JOSEPH CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 17, 1977
- Last certification
- Apr 25, 2024
- Beds
- 100
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Bethany St Joseph Corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Sep 24, 1976 in WI
- Enrollment address
- 2501 Shelby Rd
La Crosse, WI 54601-8037 - Nursing home name
- BETHANY ST JOSEPH CARE CTR
All disclosed owners & managing parties 20
| Name | Role | Since | Share |
|---|---|---|---|
| Michelle M White |
Operational/Managerial Control | Dec 2, 2024 | |
| Adp of the SNF | Dec 2, 2024 | ||
| Scott Barton |
Operational/Managerial Control | Aug 9, 1999 | |
| Adp of the SNF | Aug 9, 1999 | ||
| Edward J Malone |
Operational/Managerial Control | Dec 31, 2024 | |
| Adp of the SNF | Dec 31, 2024 | ||
| Terri Pedace |
Corporate Director |
Mar 1, 2021 | |
| Operational/Managerial Control | Jan 6, 2025 | ||
| Trustee of the SNF | Mar 1, 2021 | ||
| Adp of the SNF | Jan 6, 2025 | ||
| Nicholas Passe |
Corporate Director |
Mar 1, 2019 | |
| Operational/Managerial Control | Jan 6, 2025 | ||
| Trustee of the SNF | Mar 1, 2019 | ||
| Adp of the SNF | Jan 6, 2025 | ||
| Karlie White |
Operational/Managerial Control | Jan 1, 2016 | |
| Adp of the SNF | Jan 1, 2016 | ||
| Tisha Bennett |
Operational/Managerial Control | Nov 18, 2015 | |
| Adp of the SNF | Nov 18, 2015 | ||
| Bonita Sacie |
Corporate Director |
Mar 1, 2022 | |
| Operational/Managerial Control | Jan 6, 2025 | ||
| Trustee of the SNF | Mar 1, 2022 | ||
| Adp of the SNF | Jan 6, 2025 | ||
| Paige Schatzke |
Operational/Managerial Control | Nov 3, 2015 | |
| Adp of the SNF | Nov 3, 2015 | ||
| Dawn Kutt |
Corporate Director |
Mar 26, 2024 | |
| Operational/Managerial Control | Jan 7, 2025 | ||
| Trustee of the SNF | Mar 26, 2024 | ||
| Adp of the SNF | Jan 7, 2025 | ||
| Wipfli LLP |
Operational/Managerial Control | Jan 23, 2025 | |
| Adp of the SNF | Jan 23, 2025 | ||
| Steve Spilde |
Corporate Director |
Mar 1, 2017 | |
| Operational/Managerial Control | Jan 6, 2025 | ||
| Trustee of the SNF | Mar 1, 2017 | ||
| Adp of the SNF | Jan 6, 2025 | ||
| Kimberly a Gochanour |
Corporate Officer |
Mar 25, 2024 | 100% |
| Operational/Managerial Control | Mar 25, 2024 | ||
| Adp of the SNF | Mar 25, 2024 | ||
| Matthew Bersagel Braley |
Corporate Director |
Mar 1, 2022 | |
| Operational/Managerial Control | Dec 26, 2024 | ||
| Adp of the SNF | Jan 6, 2025 | ||
| Megan Feirtag |
Operational/Managerial Control |
Jan 31, 2017 | 100% |
| Adp of the SNF | Jan 31, 2017 | ||
| Charles Hanson |
Corporate Director |
Mar 1, 2022 | |
| Operational/Managerial Control | Jan 6, 2025 | ||
| Trustee of the SNF | Mar 1, 2022 | ||
| Adp of the SNF | Jan 6, 2025 | ||
| Kay Berra |
Corporate Director | Mar 28, 2023 | |
| Operational/Managerial Control | Jan 7, 2025 | ||
| Trustee of the SNF | Mar 28, 2023 | ||
| Adp of the SNF | Jan 7, 2025 | ||
| Erick Maki |
Corporate Director |
Mar 26, 2024 | |
| Operational/Managerial Control | Jan 7, 2025 | ||
| Trustee of the SNF | Mar 26, 2024 | ||
| Adp of the SNF | Jan 7, 2025 | ||
| Cindi Kite |
Corporate Director |
Mar 1, 2018 | |
| Operational/Managerial Control | Jan 6, 2025 | ||
| Trustee of the SNF | Mar 1, 2018 | ||
| Adp of the SNF | Jan 6, 2025 | ||
| Sean Martin |
Corporate Director |
Mar 28, 2023 | |
| Operational/Managerial Control | Jan 7, 2025 | ||
| Trustee of the SNF | Mar 28, 2023 | ||
| Adp of the SNF | Jan 7, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111115000831 | WI | Part a Provider - Skilled Nursing Facility | 9436277654 | Practice locations: La Crosse, WI |
National Provider Directory
- Tax ID family
- The Bethany-St Joseph Corporation Dba Prairie Pointe Rehab Suites
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2540 | WI | Yes |
Addresses
Primary practice location
2501 Shelby Rd
La Crosse, WI 54601-8037
Mailing address
2501 Shelby Rd
La Crosse, WI 54601-8037
Phone (608) 788-5700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20141100 | Medicaid | WI |
Other names
- BETHANY ST. JOSEPH CARE CENTER
Other providers in La Crosse, WI
- Robyn L Bernett
- Elizabeth Ann Beseler
- Mayra A Betancourt Ponce
- Bethany Lutheran Homes, Inc.
- Bethany St Joseph Corporation
- Bethany-St Joseph Corporation
- Paula M Betlach
- Geoffrey Betz
- John H. Betz
- Kay F. Bevington
All providers in La Crosse, WI · Skilled Nursing Facility in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.