NSH Shawano-Evergreen LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

NSH SHAWANO-EVERGREEN LLC

Doing business as

Evergreen Health Services

Practice address

1250 S Evergreen St
Shawano, WI 54166-3514

Phone

(715) 526-3107

NPI assigned

Oct 23, 2019

Last updated

Oct 23, 2019By 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

Jeffrey Hoehn

Title

Managing Member

Phone

(414) 962-5250

Specialties & licenses 1

Addresses

Other names 1

• Evergreen Health Services 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 1548803497. Details of each certification follow.

• CCN 525343 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 525343

Legal name

NSH SHAWANO-EVERGREEN LLC

Doing business as

EVERGREEN HEALTH SERVICES

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 1, 1983

Last certification

May 29, 2025

Beds

50

Ownership / control type

Limited Liability Corporation

Multi-facility organization

North Shore Health Care

Most recent change of ownership

Dec 1, 2003

Organization structure

LLCProprietary

Incorporated

Sep 25, 2019 in WI

Enrollment address

1250 S Evergreen St
Shawano, WI 54166-3514

Nursing home name

EVERGREEN HEALTH SERVICES

Affiliated entity

NORTH SHORE HEALTHCARE

Listed as

Evergreen Health ServicesCCN 525343 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

3 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Dec 1, 1983

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5037.5 residents per day on average

Chain

North Shore Healthcare59 facilities in the chain

Penalties (3 years)

1Fines totaling $14,020

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 20

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.

• Madhavi Reddy Cherukula, MD

  • Internal Medicine Physician
  • Appleton, WI
  • NPI 1265847396

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 134

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Bay Area Lutheran Homes Inc

  dba Woodside Lutheran Home

  • Skilled Nursing Facility
  • Green Bay, WI
  • NPI 1780756890

  Cliftonlarsonallen LLP, Wipfli LLP

  CMS ownership
• Bethany-St Joseph Corporation

  dba Onalaska Care Center

  • Skilled Nursing Facility
  • Onalaska, WI
  • NPI 1033102983

  Wipfli LLP

  CMS ownership
• Bethany-St Joseph Corporation

  dba Bethany St. Joseph Care Center

  • Skilled Nursing Facility
  • La Crosse, WI
  • NPI 1356334205

  Wipfli LLP

  CMS ownership
• County of Sheboygan

  dba Rocky Knoll Health Care Center

  • Skilled Nursing Facility
  • Plymouth, WI
  • NPI 1003988049

  Wipfli LLP

  CMS ownership
• Four Winds Manor, Inc.

  dba Four Winds Manor and Lodge, Inc.

  • Skilled Nursing Facility
  • Verona, WI
  • NPI 1902895592

  Wipfli LLP

  CMS ownership
• Good Shepherd Home, LTD

  • Skilled Nursing Facility
  • Seymour, WI
  • NPI 1235106725

  Wipfli LLP

  CMS ownership
• Great Lakes Hospice LLC

  • Community Based Hospice Care Agency
  • Glendale, WI
  • NPI 1205433778

  Arrowhead 123 LLC

  CMS ownership
• Maryhill Manor Inc

  • Skilled Nursing Facility
  • Niagara, WI
  • NPI 1336143726

  Wipfli LLP

  CMS ownership
• NSH Altoona LLC

  • Skilled Nursing Facility
  • Altoona, WI
  • NPI 1760900559

  Cibc Bank USA, Cliftonlarsonallen LLP, Continuum Therapy Partners LLC, North Shore Healthcare LLC, NSH Rehab LLC, Wipfli LLP

  CMS ownership
• NSH Ashland LLC

  dba Ashland Health Services

  • Skilled Nursing Facility
  • Ashland, WI
  • NPI 1891268454

  North Shore Healthcare LLC

  CMS ownership
• NSH Cedarburg LLC

  • Skilled Nursing Facility
  • Cedarburg, WI
  • NPI 1891213625

  North Shore Healthcare LLC

  CMS ownership
• NSH Colby LLC

  dba Colonial Health Services

  • Skilled Nursing Facility
  • Colby, WI
  • NPI 1568272763

  Cibc Bank USA, Cliftonlarsonallen LLP, Continuum Therapy Partners LLC, Wipfli LLP

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Madhavi Reddy Cherukula, MD

  • Internal Medicine Physician
  • Appleton, WI
  • NPI 1265847396
  NPD (past)

Affiliated clinicians 1

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

• Madhavi Reddy Cherukula, MD

  • Internal Medicine Physician
  • Appleton, WI
  • NPI 1265847396

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571788800000",
    "number": "1548803497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 N PORT WASHINGTON RD STE 260",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532175470",
            "telephone_number": "414-962-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S EVERGREEN ST",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541663514",
            "telephone_number": "715-526-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NSH SHAWANO-EVERGREEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-23",
        "last_updated": "2019-10-23",
        "status": "A",
        "authorized_official_last_name": "HOEHN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "414-962-5250"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel Nault, PHARMD
• Beau Nguyen, PHARMD
• NHH Vision Group, S.C. (Vision Source Shawano)
• Gregory Nordwig
• NSH Shawano-Birch LLC (Birch Hill Health Services)
• NSH Shawano-Maple LLC (Maple Lane Health Services)
• Thomas L Olmsted, CRNA
• Andrea Olsen, OTR
• Jill Olsen, APNP
• Orthopedic & Spine Therapy of Clintonville, SC

• Skilled Nursing Facility in Shawano, WI
• Providers in Shawano, 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 Oct 23, 2019; 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.