River Valley Nursing Home, Inc
Organization Active NPI Skilled Nursing Facility · Spring Green, WI
NPI 1972504835 · NPPES record last updated Aug 11, 2023
Key facts
- NPI
- 1972504835
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 2470 (WI)
- Legal business name
- RIVER VALLEY NURSING HOME, INC
- Practice address
- 501 S Winsted St
Spring Green, WI 53588-9435 - Phone
- (608) 588-2586
- Fax
- (608) 588-7410
- NPI assigned
- Aug 2, 2005
- Organization subpart
- No
Authorized official
- Name
- Brian Gorman
- Title
- Facility Administrator
- Phone
- (608) 588-0513
Owners & managing parties with NPI records 1
-
Eric L Jones, DO
Affiliated clinicians 8
-
Luke W Fortney, MD
-
Janelle K Hupp, MD
-
Eric L Jones, DO
-
Ellen L Olson, MD
-
Mark G Timmerman, MD
Medicare Care Compare: Nursing home
- Listed as
- Greenway Manor
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 1, 1986
- Medicare certification status
- Active
- Certified beds
- 50 · 47.3 residents per day on average
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0393144 | Greenway Manor | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Skilled nursing facility certification: CCN 525396
- Legal name
- RIVER VALLEY NURSING HOME INC
- Doing business as
- GREENWAY MANOR
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1986
- Last certification
- Oct 3, 2024
- Beds
- 50
- Ownership / control type
- Corporation
- Organization structure
- Corporation · Proprietary
- Incorporated
- Nov 10, 1972 in WI
- Enrollment address
- 501 S Winsted St
Spring Green, WI 53588-9435 - Nursing home name
- GREENWAY MANOR
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| |
Adp of the SNF | Nov 21, 2025 | |
| |
Adp of the SNF | Nov 21, 2025 | |
| |
Adp of the SNF | Nov 21, 2025 | |
| Mark Scoles |
Corporate Officer |
Jul 1, 2021 | 16.67% |
| Corporate Director |
Sep 20, 2017 | 16.67% | |
| |
Adp of the SNF | Nov 21, 2025 | |
| Brian Gorman |
Operational/Managerial Control | Jun 30, 2021 | |
| Adp of the SNF | Jun 30, 2021 | ||
| Direct Ownership Interest | Jun 1, 2021 | 1.15% | |
| Eric Jones |
Operational/Managerial Control | Jan 1, 2026 | |
| Adp of the SNF | Jan 1, 2026 | ||
| Kathleen Mazwell |
Corporate Officer |
Jun 30, 2021 | 16.67% |
| Corporate Director |
Apr 1, 2002 | 16.67% | |
| |
Adp of the SNF | Nov 21, 2025 | |
| |
Adp of the SNF | Nov 21, 2025 | |
| Gerald Sprecher |
Corporate Officer |
Oct 1, 2024 | 16.67% |
| Corporate Director |
Sep 1, 2010 | 16.67% | |
| Thomas Gorman |
Corporate Officer |
Sep 21, 2016 | 16.67% |
| Corporate Director |
Sep 21, 2016 | 16.67% | |
| |
Adp of the SNF | Nov 21, 2025 | |
| Sandra Shaffer |
5% Or Greater Direct Ownership Interest |
Mar 15, 2004 | 11.51% |
| Stephenson National Bank & Trust |
5% Or Greater Indirect Ownership Interest | Jan 1, 2025 | 11.17% |
| Susan Meise |
5% Or Greater Direct Ownership Interest |
Sep 25, 2001 | 13.82% |
| Corporate Director |
Apr 1, 2017 | 16.66% | |
| Alisha Hahn |
Corporate Director |
Jun 1, 2017 | 16.66% |
| Adp of the SNF | Jan 1, 2000 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111118000262 | WI | Part a Provider - Skilled Nursing Facility | 6002080595 | Practice locations: Spring Green, WI |
National Provider Directory
Locations
501 S Winsted St
Spring Green, WI 53588
Phone (608) 588-0208
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 1928 | WI | |
| Skilled Nursing Facility | 314000000X | 2470 | WI | Yes |
Addresses
Primary practice location
501 S Winsted St
Spring Green, WI 53588-9435
Mailing address
PO Box 759
Spring Green, WI 53588-0759
Phone (608) 588-2586
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20144800 | Medicaid | WI |
Other names
- Greenway Manor & Greenway Terrace
Other providers in Spring Green, WI
- Ellen L Olson
- Jillian Philipps
- Gena Reitano
- Richland Hospital
- Richland Hospital
- River Valley School District
- Chloe L Rooney
- Lindsay M. N. Rothering
- Jaden Janeen Ryan
- Sauk Prairie Healthcare Inc
All providers in Spring Green, WI · Skilled Nursing Facility in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.