Organization Active NPI

Bethany-St Joseph Corporation

Doing business as Marinuka Manor

  • Skilled Nursing Facility
  • Galesville, WI
National Provider Identifier
1750374609
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2498 Issued in WI
Legal business name
BETHANY-ST JOSEPH CORPORATION
Doing business as
Marinuka Manor
Practice address
19475 Silver Creek Rd
Galesville, WI 54630-6400
Phone
(608) 582-2211
Fax
(608) 582-4068
NPI assigned
Aug 25, 2005
Last updated
Dec 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Authorized official

Name
Kimberly Gochanour
Title
Ceo
Phone
(608) 788-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2498 WI Primary

Addresses

Primary practice location

19475 Silver Creek Rd
Galesville, WI 54630-6400

Mailing address

19475 Silver Creek Rd
Galesville, WI 54630-6400
Phone (608) 582-2211

Other identifiers 1

IdentifierTypeStateIssuer
20143500MedicaidWI

Other names 1

  • MARINUKA MANOR Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111115000879 WI Part A Provider - Skilled Nursing Facility 9436277654 Practice locations: Galesville, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750374609. Details of each certification follow.

Skilled nursing facility certification: CCN 525628

Legal name
BETHANY-ST JOSEPH CORPORATION
Doing business as
MARINUKA MANOR
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1997
Last certification
Nov 6, 2024
Beds
50
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Bethany St. Joseph Corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 24, 1976 in WI
Enrollment address
19475 Silver Creek Rd
Galesville, WI 54630-6400
Nursing home name
MARINUKA MANOR

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Marinuka ManorCCN 525628 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Aug 1, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5034.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D0678951Marinuka Manor19475 Silver Creek Rd, Galesville, WI 54630Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
The Bethany-St Joseph Corporation Dba Prairie Pointe Rehab Suites6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

19475 Silver Creek Rd
Galesville, WI 54630
Phone (608) 582-2211

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Terri Pedace Individual Corporate DirectorBoard Member Mar 1, 2021 100%
Nicholas Passe Individual Corporate DirectorBoard Vice President Mar 1, 2019 100%
Barbara Strohm Individual Corporate DirectorBoard Secretary Mar 21, 2014 100%
Joseph L Kotnour Individual Corporate DirectorBoard Treasurer Mar 21, 2015 100%
Bradley R Quarberg Individual Corporate DirectorBoard Chairman/Board President Mar 21, 2014 100%
Bonita Sacie Individual Corporate DirectorBoard Member Mar 1, 2022 100%
Steve Spilde Individual Corporate DirectorBoard Member Mar 1, 2017 100%
Matthew Bersagel Braley Individual Corporate DirectorBoard Member Mar 1, 2022 100%
Megan Feirtag Individual Operational/Managerial ControlVice President of Health Care Apr 10, 2022 100%
Charles Hanson Individual Corporate DirectorBoard Member Mar 1, 2022 100%
Joyce Wichelt Individual Corporate DirectorBoard Member Mar 1, 2014 100%
Paul Patros Individual Corporate DirectorBoard Member Mar 1, 2017 100%
Craig D Ubbelohde Individual Corporate OfficerCeo Mar 26, 2012 100%
Cindi Kite Individual Corporate DirectorBoard Member Mar 1, 2018 100%
Elaine Zeman Individual Corporate OfficerCfo Mar 27, 2021 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1750374609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19475 SILVER CREEK RD",
            "city": "GALESVILLE",
            "state": "WI",
            "postal_code": "546306400",
            "telephone_number": "608-582-2211",
            "fax_number": "608-582-4068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19475 SILVER CREEK RD",
            "city": "GALESVILLE",
            "state": "WI",
            "postal_code": "546306400",
            "telephone_number": "608-582-2211",
            "fax_number": "608-582-4068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY-ST JOSEPH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-25",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A",
        "authorized_official_last_name": "GOCHANOUR",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "608-788-5700"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20143500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARINUKA MANOR",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MARINUKA MANOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Galesville, WI

Sources for this page

Verify at the official NPI Registry.