American Lutheran Church-Northland Luthern Services for the Elderly, I

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2155 Issued in WI

Legal business name

AMERICAN LUTHERAN CHURCH-NORTHLAND LUTHERN SERVICES FOR THE ELDERLY, I

Doing business as

Luther Home

Practice address

831 Pine Beach Rd
Marinette, WI 54143-4225

Phone

(715) 732-0155

Fax

(715) 732-5899

NPI assigned

May 31, 2005

Last updated

Aug 22, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gary Gustafson

Title

Director of Finance

Phone

(715) 732-0155

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Luther Home Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376546762. Details of each certification follow.

• CCN 525476 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 525476

Legal name

AMERICAN LUTHERAN CHURCH-NORTHLAND LUTHERN SERVICES FOR THE ELDERLY, I

Doing business as

LUTHER HOME

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 1, 1991

Last certification

Aug 21, 2024

Beds

80

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Nov 11, 1988 in WI

Enrollment address

831 Pine Beach Rd
Marinette, WI 54143-4225

Nursing home name

LUTHER HOME

Listed as

Luther HomeCCN 525476 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Aug 1, 1991

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

8059.4 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 3

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

Affiliated clinicians 4

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

• Matthew Brian Kowalke, MD

  • Internal Medicine Physician
  • Marinette, WI
  • NPI 1932605425

  Nursing home

  Care Compare affiliation
• Jon L Simmons, MD

  • Family Medicine Physician
  • Marinette, WI
  • NPI 1336189075

  Nursing home

  Care Compare affiliation
• Pawneet P Singh, MD

  • Family Medicine Physician
  • Crivitz, WI
  • NPI 1174779243

  Nursing home

  Care Compare affiliation
• Ivy Marie Vachon

  • Family Medicine Physician
  • Marquette, MI
  • NPI 1992119606

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471824000000",
    "number": "1376546762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 PINE BEACH RD",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434225",
            "telephone_number": "715-732-0155",
            "fax_number": "715-732-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 PINE BEACH RD",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434225",
            "telephone_number": "715-732-0155",
            "fax_number": "715-732-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN LUTHERAN CHURCH-NORTHLAND LUTHERN SERVICES FOR THE ELDERLY, I",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2016-08-22",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "715-732-0155",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20126700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Luther Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danielle Adams, SAC-IT
• Advanced Physical Therapy & Sports Medicine SC
• Thea J Aguon, OT
• Siddhanth Ahluwalia, MD
• Emmanouil Alimpertis, M.D.
• Amy L Anderson, LPN
• Carrie Anderson, RN
• Hayward Anderson, R.PH.
• Lisa Anderson
• Susan E Arcaro, DO

• Skilled Nursing Facility in Marinette, WI
• Providers in Marinette, 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 Aug 22, 2016; 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.