Active NPI
New Glarus Home, Inc
- Skilled Nursing Facility
- New Glarus, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 2605
- Legal business name
- NEW GLARUS HOME, INC
- Practice address
- 600 2ND Ave
New Glarus, WI 53574-9776 - Phone
- (608) 527-2126
- Fax
- (608) 527-5365
- NPI assigned
- Oct 3, 2005
- 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
- Mr. David Wickline
- Title
- Authorized Official
- Phone
- (608) 527-2126
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2605 | WI | Primary |
Addresses
Primary practice location
600 2ND Ave
New Glarus, WI 53574-9776
Mailing address
600 2ND Ave
New Glarus, WI 53574-9776
Phone (608) 527-2126
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20104200 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111214000257 | WI | Part A Provider - Skilled Nursing Facility | 1153596556 | Practice locations: New Glarus, WI |
Skilled nursing facility certification: CCN 525630
- Legal name
- NEW GLARUS HOME, INC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1997
- Last certification
- Dec 5, 2024
- Beds
- 100
- Ownership / control type
- Church Related
- Organization structure
- Corporation
- Incorporated
- Jan 6, 1966 in WI
- Enrollment address
- 600 2ND Ave
New Glarus, WI 53574-9776 - Nursing home name
- NEW GLARUS HOME
Care Compare: Nursing home
Medicare Care Compare- Listed as
- New Glarus Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Church related
- Certified
- Jul 1, 1997
- Medicare certification status
- Active
- Certified beds
- 100
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 3
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 |
|---|---|---|---|
| 52D0393083 | New Glarus Home | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 19
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 |
|---|---|---|---|
| Matt Streiff | Corporate Director | Jan 4, 2023 | |
| Operational/Managerial Control | Jan 4, 2023 | ||
| Adp of the SNF | Jan 4, 2023 | ||
| Joan Moen | Corporate Director | Jul 1, 2024 | |
| Operational/Managerial Control | Jul 1, 2024 | ||
| Omnicare | Operational/Managerial Control | Jun 5, 2025 | |
| Adp of the SNF | Apr 1, 2025 | ||
| GL Rehab | Adp of the SNF | Jan 4, 2023 | |
| Adp of the SNF | Mar 24, 2025 | ||
| Wipfli LLP | Adp of the SNF | Jan 4, 2023 | |
| Christine Kirsz | Corporate Director | Jan 1, 2025 | |
| Operational/Managerial Control | Jan 1, 2025 | ||
| Joann Shepherd | Corporate Director | Nov 1, 2024 | |
| Operational/Managerial Control | Nov 1, 2024 | ||
| Adp of the SNF | Nov 1, 2024 | ||
| Mary Funseth | Corporate Director | Jul 1, 2024 | |
| Operational/Managerial Control | Jul 1, 2024 | ||
| Adp of the SNF | Apr 7, 2025 | ||
| Adp of the SNF | Feb 1, 2024 | ||
| Mark Douma | Corporate Director | Jul 1, 2024 | |
| Operational/Managerial Control | Jul 1, 2023 | ||
| Janis Roesslein | Corporate Director | Jul 1, 2023 | |
| Operational/Managerial Control | Jul 1, 2023 | ||
| Karl Lueschow | Corporate Director | Jul 1, 2024 | |
| Operational/Managerial Control | Jul 1, 2024 | ||
| Jill Klossner | Corporate Director | Jul 1, 2023 | |
| Operational/Managerial Control | Jul 1, 2023 | ||
| David Cunningham | Corporate Director | Jun 1, 2023 | |
| Operational/Managerial Control | Jul 1, 2024 | ||
| David Wickline | Corporate Director | Jun 1, 2023 | |
| Operational/Managerial Control | Jul 1, 2022 | ||
| Patrick Meier | Corporate Director | Jul 1, 2014 | |
| Operational/Managerial Control | Jan 4, 2023 | ||
| David L Rebedew | Corporate Director | Jun 1, 2019 | |
| Operational/Managerial Control | Jun 1, 2019 | ||
| Adp of the SNF | Jan 4, 2023 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Geriatric Medicine (Family Medicine) Physician
- Monroe, WI
- NPI 1184966509
Adp of the SNF, Corporate Director, Operational/Managerial Control
Practitioners & affiliated clinicians
Affiliated clinicians 6
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Medicine Physician
- Windsor, WI
- NPI 1306112172
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128297600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1729468800000",
"number": "1376530592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 2ND AVE",
"city": "NEW GLARUS",
"state": "WI",
"postal_code": "535749776",
"telephone_number": "608-527-2126",
"fax_number": "608-527-5365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 2ND AVE",
"city": "NEW GLARUS",
"state": "WI",
"postal_code": "535749776",
"telephone_number": "608-527-2126",
"fax_number": "608-527-5365"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEW GLARUS HOME, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-03",
"last_updated": "2024-10-21",
"certification_date": "2024-10-21",
"status": "A",
"authorized_official_last_name": "WICKLINE",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "608-527-2126",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WI",
"license": "2605",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20104200",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New Glarus, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.