NPIMap

Organization Active NPI

Marquardt Memorial Manor, Inc.

Doing business as Marquardt Health Center

  • Skilled Nursing Facility
  • Watertown, WI
National Provider Identifier
1821091323
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2143 Issued in WI
Legal business name
MARQUARDT MEMORIAL MANOR, INC.
Doing business as
Marquardt Health Center
Marquardt Health and Rehab Center
Practice address
1020 Hill St
Watertown, WI 53098-3016
Phone
(920) 261-0400
Fax
(920) 261-4840
NPI assigned
May 27, 2005
Last updated
Jul 10, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MARQUARDT VILLAGE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Authorized official

Name
Julie Anne Marks
Title
Cfo
Phone
(920) 261-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2143 WI Primary

Addresses

Primary practice location

1020 Hill St
Watertown, WI 53098-3016

Mailing address

1045 Hill St
Watertown, WI 53098-3015
Phone (920) 261-0400

Other identifiers 2

IdentifierTypeStateIssuer
20139200MedicaidWI
534433OtherWIDEAN HEALTH PLAN

Other names 2

  • Marquardt Health Center Doing business as
  • Marquardt Health and Rehab Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040714000198 WI Part A Provider - Skilled Nursing Facility 9638158744 Practice locations: Watertown, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821091323. Details of each certification follow.

Skilled nursing facility certification: CCN 525543

Legal name
MARQUARDT MEMORIAL MANOR, INC.
Doing business as
MARQUARDT MEMORIAL MANOR, INC.
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1994
Last certification
Sep 26, 2024
Beds
140
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 26, 1996 in WI
Enrollment address
1020 Hill St
Watertown, WI 53098-3016
Nursing home name
MARQUARDT MEMORIAL MANOR
Affiliated entity
ILLUMINUS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Marquardt Memorial ManorCCN 525543 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Aug 1, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
14073.3 residents per day on average
Chain
Illuminus5 facilities in the chain
Penalties (3 years)
2Fines totaling $26,706

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
52D0669018Marquardt Memorial Manor Inc1020 Hill St, Watertown, WI 53098Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Matthew R Mauthe Individual Corporate OfficerChief Executive Officer May 10, 2010
Operational/Managerial Control May 10, 2010
Adp of the SNF May 10, 2010
Todd Fischer Individual Corporate DirectorBoard Chair Nov 25, 2019
Michael E Sullivan Individual Operational/Managerial Control Dec 1, 2012
Adp of the SNF Aug 25, 2025
Illuminus Inc Organization, Watertown, WI Corporation, Management services company, Non-profit Operational/Managerial Control Jul 1, 2017
Adp of the SNF Aug 22, 2025
Scott Dettman Individual Corporate DirectorBoard Member Nov 29, 2021
Robert Meidenbauer Individual Corporate DirectorBoard Vice Chair Nov 29, 2021
Marquardt Village Inc Organization, Watertown, WI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Sep 12, 2011 100%
Julie Marks Individual Corporate OfficerCfo Aug 25, 2025
Operational/Managerial Control Aug 25, 2025
Adp of the SNF Aug 25, 2025
Jennifer K Johnson Individual Operational/Managerial Control Sep 30, 2016
Adp of the SNF Aug 25, 2025

Owners & managing parties with NPI records 1

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

Facilities with the same owner 12

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

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": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1821091323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 HILL ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983015",
            "telephone_number": "920-261-0400",
            "fax_number": "920-261-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 HILL ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983016",
            "telephone_number": "920-261-0400",
            "fax_number": "920-261-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARQUARDT MEMORIAL MANOR, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARQUARDT VILLAGE, INC",
        "enumeration_date": "2005-05-27",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-261-0400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20139200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLAN",
            "identifier": "534433",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marquardt Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marquardt Health and Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watertown, WI

Sources for this page

Verify at the official NPI Registry.