Manor of Fond Du Lac LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MANOR OF FOND DU LAC LLC

Practice address

517 E Division St
Fond Du Lac, WI 54935-3735

Phone

(920) 921-6800

NPI assigned

Aug 24, 2021

Organization subpart

No

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

Authorized official

Name

Aaron Topper

Title

Member

Phone

(847) 983-4860

Specialties & licenses 1

Addresses

Other names 1

• Avina on Division Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Skilled nursing facility certification: CCN 525522

Legal name

MANOR OF FOND DU LAC LLC

Doing business as

AVINA ON DIVISION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 24, 1993

Last certification

Mar 27, 2024

Beds

50

Ownership / control type

Limited Liability Corporation

Most recent change of ownership

Oct 22, 2021

Organization structure

LLCProprietary

Enrollment address

517 E Division St
Fond Du Lac, WI 54935-3735

Nursing home name

AVINA ON DIVISION

Affiliated entity

AVINA HEALTHCARE

Listed as

Avina on DivisionCCN 525522

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

1 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Aug 24, 1993

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5034.5 residents per day on average

Chain

Avina Healthcare9 facilities in the chain

Penalties (3 years)

1Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Ability Network Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• The Manor of Fond Du Lac LLC

  • Assisted Living Facility
  • Fond Du Lac, WI
  • NPI 1477217669
  NPD tax ID

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.

• Lisa R Weber, MD

  • Family Medicine Physician
  • Fond Du Lac, WI
  • NPI 1881883635

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781136000000",
    "number": "1376210849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8150 CENTRAL PARK AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762974",
            "telephone_number": "847-983-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353735",
            "telephone_number": "920-921-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR OF FOND DU LAC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-24",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A",
        "authorized_official_last_name": "TOPPER",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "847-983-4860"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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": "Avina on Division",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grant Manke, DPT
• Nicole J Mann
• Alexander Mannebach
• Michael D Mannebach, MD
• Manor Care of Fond Du Lac Wi LLC
• Emily Jane Mans, PTA
• Johanna Manthey, LCSW
• Heidi Noelle Marendiuk, CRNA
• Ryan B Marendiuk, DNP
• Joseph P Marik, MD

• Skilled Nursing Facility in Fond Du Lac, WI
• Providers in Fond Du Lac, 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 Jun 11, 2026; 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.