Active NPI
Bethany-St Joseph Corporation
Doing business as Marinuka Manor
- Skilled Nursing Facility
- Galesville, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 2498
- 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, 2024
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20143500 | Medicaid | WI |
Other names 1
- MARINUKA MANOR
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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).
-
dba Onalaska Care Center
- Skilled Nursing Facility
- Onalaska, WI
- NPI 1033102983
9436277654
-
dba Bethany St. Joseph Care Center
- Skilled Nursing Facility
- La Crosse, WI
- NPI 1356334205
9436277654
-
dba Norseland Nursing Home
- Skilled Nursing Facility
- Westby, WI
- NPI 1508859208
9436277654
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Marinuka Manor
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Aug 1, 1997
- Medicare certification status
- Active
- Certified beds
- 50
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0678951 | Marinuka Manor | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- The Bethany-St Joseph Corporation Dba Prairie Pointe Rehab Suites
Other organizations with this tax ID 5
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Onalaska Care Center
- Skilled Nursing Facility
- Onalaska, WI
- NPI 1033102983
-
dba Bethany St. Joseph Care Center
- Skilled Nursing Facility
- La Crosse, WI
- NPI 1356334205
-
dba Norseland Nursing Home
- Skilled Nursing Facility
- Westby, WI
- NPI 1508859208
-
dba Merit Center
- Adult Day Care Clinic/Center
- La Crosse, WI
- NPI 1811547037
-
dba Prairie Pointe Rehab Suites
- Skilled Nursing Facility
- Altoona, WI
- NPI 1982155248
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Terri Pedace | Corporate Director | Mar 1, 2021 | 100% |
| Nicholas Passe | Corporate Director | Mar 1, 2019 | 100% |
| Barbara Strohm | Corporate Director | Mar 21, 2014 | 100% |
| Joseph L Kotnour | Corporate Director | Mar 21, 2015 | 100% |
| Bradley R Quarberg | Corporate Director | Mar 21, 2014 | 100% |
| Bonita Sacie | Corporate Director | Mar 1, 2022 | 100% |
| Steve Spilde | Corporate Director | Mar 1, 2017 | 100% |
| Matthew Bersagel Braley | Corporate Director | Mar 1, 2022 | 100% |
| Megan Feirtag | Operational/Managerial Control | Apr 10, 2022 | 100% |
| Charles Hanson | Corporate Director | Mar 1, 2022 | 100% |
| Joyce Wichelt | Corporate Director | Mar 1, 2014 | 100% |
| Paul Patros | Corporate Director | Mar 1, 2017 | 100% |
| Craig D Ubbelohde | Corporate Officer | Mar 26, 2012 | 100% |
| Cindi Kite | Corporate Director | Mar 1, 2018 | 100% |
| Elaine Zeman | Corporate Officer | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.