NPIMap

Organization Active NPI

Jackson Pine View Healthcare, LLC

  • Skilled Nursing Facility
  • Black River Falls, WI
National Provider Identifier
1831209709
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2440 Issued in WI
Legal business name
JACKSON PINE VIEW HEALTHCARE, LLC
Practice address
400 County Road R
Black River Falls, WI 54615-5129
Phone
(715) 284-5396
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Dawn M Marsh
Title
Vice President
Phone
(608) 242-5024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2440 WI Primary

Addresses

Primary practice location

400 County Road R
Black River Falls, WI 54615-5129

Mailing address

400 County Road R
Black River Falls, WI 54615-5129
Phone (608) 225-2516

Other identifiers 1

IdentifierTypeStateIssuer
20198400MedicaidWI

Other names 1

  • Pine View Nursing Home Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070501000613 WI Part A Provider - Skilled Nursing Facility 2769588177 Practice locations: Black River Falls, WI

Skilled nursing facility certification: CCN 525409

Legal name
JACKSON PINE VIEW HEALTHCARE, LLC
Doing business as
PINE VIEW CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1987
Last certification
Jul 3, 2024
Beds
95
Ownership / control type
Limited Liability Corporation
Organization structure
CorporationProprietary
Incorporated
Apr 1, 2007 in WI
Enrollment address
400 County Road R
Black River Falls, WI 54615-5129
Nursing home name
PINE VIEW CARE CENTER
Affiliated entity
REAL PROPERTY HEALTH FACILITIES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pine View Care CenterCCN 525409
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 1, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9533.4 residents per day on average
Chain
Real Property Health Facilities9 facilities in the chain

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
52D0396365Pine View Nursing Home400 County Rd R, Black River Falls, WI 54615Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Leslie Sutter Individual W-2 Managing EmployeeAdminstrator Nov 1, 2020 50%
Dawn M Marsh Individual Corporate OfficerVP Apr 15, 1994 50%
Operational/Managerial ControlVP Sep 21, 2015 5%
Albert V Haworth Individual Corporate OfficerPresident/Ceo May 1, 2021 15%
Operational/Managerial ControlPresident/Ceo May 1, 2021 5%
Real Property Health Facilities Corp Organization, Las Vegas, NV Corporation Operational/Managerial Control Aug 1, 1989 100%
Christina J Penn Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2015 100%
Other Jun 1, 2015 50%
Christina Jayne Penn Management Trust Organization, Las Vegas, NV 5% Or Greater Direct Ownership Interest Nov 1, 2010 100%

Facilities with the same owner 8

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

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1831209709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COUNTY ROAD R",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155129",
            "telephone_number": "608-225-2516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COUNTY ROAD R",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546155129",
            "telephone_number": "715-284-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PINE VIEW HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "MARSH",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "608-242-5024"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20198400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine View Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Black River Falls, WI

Sources for this page

Verify at the official NPI Registry.