Bethel Lutheran Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10644 Issued in SD

Legal business name

BETHEL LUTHERAN HOME

Practice address

1001 S Egan Ave
Madison, SD 57042-3336

Phone

(605) 256-4539

Fax

(605) 256-4007

NPI assigned

Nov 7, 2005

Organization subpart

No

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

Authorized official

Name

Mr. James T Iverson

Title

Administrator

Phone

(605) 256-4936

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Skilled nursing facility certification: CCN 435076

Legal name

BETHEL LUTHERAN HOME

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 1, 1994

Last certification

Jan 18, 2024

Beds

59

Ownership / control type

Church Related

Organization structure

CorporationNon-profit

Incorporated

Dec 31, 1959 in SD

Enrollment address

1001 S Egan Ave
Madison, SD 57042-3336

Nursing home name

BETHEL LUTHERAN HOME

Listed as

Bethel Lutheran HomeCCN 435076

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Church related

Certified

Apr 1, 1994

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5954.7 residents per day on average

Penalties (3 years)

2Fines totaling $56,430

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

Locations

All disclosed owners & managing parties 8

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.

• Justin A Clem, M.D.

  • Family Medicine Physician
  • Madison, SD
  • NPI 1083050827

  Adp of the SNF, Contracted Managing Employee, Indirect Ownership Interest, Operational/Managerial Control

  CMS ownership

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Johnson, PTA

  • Physical Therapy Assistant
  • Cedar Falls, IA
  • NPI 1235333147
  NPD
• Justin A Clem, M.D.

  • Family Medicine Physician
  • Madison, SD
  • NPI 1083050827
  NPD (past)
• Laura Hoefert, M.D.

  • Family Medicine Physician
  • Madison, SD
  • NPI 1750624177
  NPD (past)
• Ben Liscano, MD

  • Family Medicine Physician
  • Madison, SD
  • NPI 1326301128
  NPD (past)

Affiliated clinicians 5

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

• Mary W Beecher, M.D.

  • Family Medicine Physician
  • Madison, SD
  • NPI 1710964531

  Nursing home

  Care Compare affiliation
• Justin A Clem, M.D.

  • Family Medicine Physician
  • Madison, SD
  • NPI 1083050827

  Nursing home

  Care Compare affiliation
• Laura Hoefert, M.D.

  • Family Medicine Physician
  • Madison, SD
  • NPI 1750624177

  Nursing home

  Care Compare affiliation
• Carl Lang, MD

  • Family Medicine Physician
  • Madison, SD
  • NPI 1245972314

  Nursing home

  Care Compare affiliation
• Ben Liscano, MD

  • Family Medicine Physician
  • Madison, SD
  • NPI 1326301128

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497736615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S EGAN AVE",
            "city": "MADISON",
            "state": "SD",
            "postal_code": "570423336",
            "telephone_number": "605-256-4539",
            "fax_number": "605-256-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S EGAN AVE",
            "city": "MADISON",
            "state": "SD",
            "postal_code": "570423336",
            "telephone_number": "605-256-4539",
            "fax_number": "605-256-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL LUTHERAN HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IVERSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "605-256-4936",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SD",
            "license": "10644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150390",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avera Home Medical Equipment, LLC
• Jackie Joanne Bau, FNP-C
• Megan Bechen, PHARM.D.
• Mary W Beecher, M.D.
• Judson J Bergan, OD
• Paul Bindert
• Abigayle Rose Blanchette, PHARMD
• Michael Steven Brooke, OD
• Tonya D Buchholz, CNP
• Ryan Buse, M.D.

• Skilled Nursing Facility in Madison, SD
• Providers in Madison, SD by specialty
• Skilled Nursing Facility in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.