NPIMap

Organization Active NPI

Winona Senior Services, Inc.

Doing business as Lake Winona Manor

  • Skilled Nursing Facility
  • Winona, MN
National Provider Identifier
1962442756
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
328588 Issued in MN
Legal business name
WINONA SENIOR SERVICES, INC.
Doing business as
Lake Winona Manor
Practice address
865 Mankato Ave
Winona, MN 55987-4868
Phone
(507) 457-4366
Fax
(507) 457-4413
NPI assigned
Jun 8, 2006
Last updated
Jul 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Authorized official

Name
Ms. Rachelle Heising- Schultz
Title
Ceo
Phone
(507) 457-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 328588 MN Primary

Addresses

Primary practice location

865 Mankato Ave
Winona, MN 55987-4868

Mailing address

865 Mankato Ave
Winona, MN 55987-4868
Phone (507) 457-4366

Other names 1

  • Lake Winona Manor Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100220000415 MN Part A Provider - Skilled Nursing Facility 7911081948 Practice locations: Winona, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962442756. Details of each certification follow.

Skilled nursing facility certification: CCN 245240

Legal name
WINONA SENIOR SERVICES, INC
Doing business as
LAKE WINONA MANOR
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 1, 1982
Last certification
Dec 5, 2024
Beds
80
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 6, 1894 in MN
Enrollment address
865 Mankato Ave
Winona, MN 55987-4868
Nursing home name
LAKE WINONA MANOR

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lake Winona ManorCCN 245240 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Feb 1, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8063.9 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
24D2190644Lake Winona Manor865 Mankato Avenue, Winona, MN 55987Certificate of waiverAug 17, 2026

National Provider Directory

National Provider Directory
Tax ID family
Adith Miller Manor5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Kenneth a Mogren Individual Corporate DirectorBoard Member Jan 1, 2007
Mark S Wagner Individual Corporate DirectorBoard Member Jan 1, 2007
Linda Atkinson Individual W-2 Managing EmployeeNursing Home Administrator Nov 5, 2018
Nicholas Modjeski Individual Corporate DirectorBoard Member, Physician Dec 1, 2017
Greg Evans Individual Corporate DirectorBoard Member Jun 1, 2016
Brian Semling Individual Corporate DirectorBoard Member Nov 1, 2016
David M Gilmer Individual Corporate DirectorBoard Member Aug 1, 2018
Vicky L Decker Individual Corporate DirectorBoard Member Jan 1, 2007
Steven L Blue Individual Corporate DirectorBoard Member Jan 1, 2007
Robert Williams Individual Corporate DirectorBoard Member Nov 1, 2016
Brett S Whyte Individual Corporate DirectorBoard Member, Physician Oct 18, 2016
Rodney Baker Individual Corporate DirectorBoard Member Jan 1, 2014
Hugh Miller Individual Corporate DirectorBoard Member Jan 1, 1993
Jan Brosnahan Individual Corporate DirectorCfo, Authorized Official Aug 1, 2011
Operational/Managerial ControlCfo, Authorized Official Sep 24, 2013
Sandra Burke Individual Corporate DirectorBoard Member Jan 1, 2016
Matthew Broghammer Individual Corporate DirectorPhysician, Board Member Jan 1, 2007
Katrina R Hammel Individual Corporate DirectorMedical Director Feb 1, 2019
Fatima Said Individual Corporate DirectorBoard Member Aug 1, 2018
Winona Health Services Organization, Winona, MN Corporation 5% Or Greater Direct Ownership Interest Jul 1, 2011 100%
Todd Paulson Individual Corporate DirectorBoard Member Aug 1, 2018
Robin J Hoeg Individual Operational/Managerial ControlService Line Leader of Inpatient Jul 1, 2014
Rachelle Heising-Schultz Individual Corporate DirectorCeo, President, Authorized Offic Jan 1, 2007
Operational/Managerial ControlPresident, Ceo, Authorized Offic Jul 1, 2002
Audrey Ceplecha Individual W-2 Managing EmployeeDirector of Revenue Cycle Nov 1, 2021
Operational/Managerial ControlDirector of Revenue Cycle Nov 1, 2021

Owners & managing parties with NPI records 11

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1962442756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 MANKATO AVE",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559874868",
            "telephone_number": "507-457-4366",
            "fax_number": "507-457-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 MANKATO AVE",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559874868",
            "telephone_number": "507-457-4366",
            "fax_number": "507-457-4413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINONA SENIOR SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A",
        "authorized_official_last_name": "HEISING- SCHULTZ",
        "authorized_official_first_name": "RACHELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "507-457-4300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "328588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Winona Manor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Winona Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winona, MN

Sources for this page

Verify at the official NPI Registry.