Manawa Community Nursing Center Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2616 Issued in WI

Legal business name

MANAWA COMMUNITY NURSING CENTER INC.

Practice address

400 E 4TH St
Manawa, WI 54949

Phone

(920) 596-2566

Fax

(920) 596-2588

NPI assigned

May 27, 2005

Last updated

Dec 14, 2009By 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. Russell Joseph Maticek Sr.

Title

Owner

Phone

(920) 596-2566

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649273350. Details of each certification follow.

• CCN 525316 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 525316

Legal name

MANAWA COMMUNITY NURSING CENTER INC.

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jun 1, 1982

Last certification

Mar 12, 2024

Beds

25

Ownership / control type

Individual

Organization structure

CorporationProprietary

Incorporated

Nov 19, 1979 in WI

Enrollment address

400E 4TH St
Manawa, WI 54949-9227

Nursing home name

MANAWA COM NUR CTR

Listed as

Manawa Com Nur CTRCCN 525316 · All quality measures

Overall star rating

1 of 5

Health inspections

2 of 5

Staffing

1 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Individual

Certified

Jun 1, 1982

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

2521.2 residents per day on average

Penalties (3 years)

3Fines totaling $17,716

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 2

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

Affiliated clinicians 1

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

• Steven A Goedderz, MD

  • Family Medicine Physician
  • New London, WI
  • NPI 1841226818

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260748800000",
    "number": "1649273350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 4TH ST",
            "city": "MANAWA",
            "state": "WI",
            "postal_code": "549499227",
            "telephone_number": "920-596-2566",
            "fax_number": "920-596-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 4TH ST",
            "city": "MANAWA",
            "state": "WI",
            "postal_code": "54949",
            "telephone_number": "920-596-2566",
            "fax_number": "920-596-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANAWA COMMUNITY NURSING CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2009-12-14",
        "status": "A",
        "authorized_official_last_name": "MATICEK",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-596-2566",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20105000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Lynn Bartz-Bentz, O.T.R.
• Amanda L. Beck, PTA
• Tina Bettin, NP
• Wendy Beyer, R.D.H.
• Briana Draeger
• Manawa Rural Fire Dept
• Robert Kevin Reilly, DDS
• Valerie Schmude, MS, LPC
• School District of Manawa
• Sell Chiropractic

• Skilled Nursing Facility in Manawa, WI
• Providers in Manawa, 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 Dec 14, 2009; 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.