Active NPI
Chippewa Manor Nursing and Rehabilitation Corporation
- Skilled Nursing Facility
- Chippewa Falls, WI
National Provider Identifier
1881690873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 2627
- Legal business name
- CHIPPEWA MANOR NURSING AND REHABILITATION CORPORATION
- Practice address
- 222 Chapman Rd
Chippewa Falls, WI 54729-3253 - Phone
- (715) 723-4437
- Fax
- (715) 723-0524
- NPI assigned
- Jun 23, 2005
- 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
- Brandon Thorsness
- Title
- President
- Phone
- (715) 723-4437
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2627 | WI | Primary |
Addresses
Primary practice location
222 Chapman Rd
Chippewa Falls, WI 54729-3253
Mailing address
222 Chapman Rd
Chippewa Falls, WI 54729-3253
Phone (715) 723-4437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20105700 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080326000889 | WI | Part A Provider - Skilled Nursing Facility | 1557447828 | Practice locations: Chippewa Falls, WI |
Skilled nursing facility certification: CCN 525419
- Legal name
- CHIPPEWA MANOR NURSING AND REHABILITATION CORPORATION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 9, 1989
- Last certification
- Jan 29, 2025
- Beds
- 50
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Incorporated
- Apr 9, 1980 in WI
- Enrollment address
- 222 Chapman Rd
Chippewa Falls, WI 54729-3253 - Nursing home name
- CHIPPEWA MANOR NURSING AND REHABILITATION
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Chippewa Manor Nursing and Rehabilitation
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 9, 1989
- Medicare certification status
- Active
- Certified beds
- 50
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 5
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 |
|---|---|---|---|
| Darrell Rubel | 5% Or Greater Indirect Ownership Interest | Feb 9, 1989 | 100% |
| Corporate Officer | Feb 9, 1989 | 100% | |
| Brandon P Thorsness | Corporate Officer | Jan 1, 2018 | |
| W-2 Managing Employee | Oct 27, 2014 | ||
| Scott Nicastro | Corporate Officer | Oct 19, 2011 | |
| Corporate Director | Oct 19, 2011 | ||
| Jeffrey Thiess | Corporate Officer | Oct 19, 2011 | |
| Corporate Director | Oct 19, 2011 | ||
| Chippewa Manor Corporation | 5% Or Greater Direct Ownership Interest | Jan 29, 2009 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 1
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": "1119484800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1518393600000",
"number": "1881690873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 CHAPMAN RD",
"city": "CHIPPEWA FALLS",
"state": "WI",
"postal_code": "547293253",
"telephone_number": "715-723-4437",
"fax_number": "715-723-0524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 CHAPMAN RD",
"city": "CHIPPEWA FALLS",
"state": "WI",
"postal_code": "547293253",
"telephone_number": "715-723-4437",
"fax_number": "715-723-0524"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHIPPEWA MANOR NURSING AND REHABILITATION CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-23",
"last_updated": "2018-02-12",
"status": "A",
"authorized_official_last_name": "THORSNESS",
"authorized_official_first_name": "BRANDON",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "715-723-4437"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WI",
"license": "2627",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20105700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chippewa Falls, WI
- Chippewa Falls Area School District
- Chippewa Falls Assisted Living LLC
- Chippewa Falls Chiropractic, S.C.
- Chippewa Falls Rcac, LLC
- Chippewa Fire Protection District Inc.
- Chippewa Pharmacy Inc
- Chippewa Valley Eye Clinic Chippewa Falls SC
- Chippewa Valley Eye Clinic SC
- Chippewa Valley Health Cooperative
- Chippewa Valley Independent Psychiatry LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; 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.