NPIMap

Organization Active NPI

Dac of Copperhill LLC

Doing business as Diversicare of Copper Basin

  • Skilled Nursing Facility
  • Copperhill, TN
National Provider Identifier
1003629809
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
DAC OF COPPERHILL LLC
Doing business as
Diversicare of Copper Basin
Practice address
166 Industrial Dr
Copperhill, TN 37317-5632
Phone
(423) 496-3245
NPI assigned
Jan 28, 2025
Last updated
Sep 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Authorized official

Name
Matthew J. Weishaar
Title
Chief Financial Officer & Secretary
Phone
(615) 771-7575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

166 Industrial Dr
Copperhill, TN 37317-5632

Mailing address

730 Cool Springs Blvd Ste 200
Franklin, TN 37067-7290
Phone (615) 550-9453

Other names 1

  • Diversicare of Copper Basin Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260130000342 TN Part A Provider - Skilled Nursing Facility 5496233587 Practice locations: Copperhill, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003629809. Details of each certification follow.

Skilled nursing facility certification: CCN 445310

Legal name
DAC OF COPPERHILL LLC
Doing business as
DIVERSICARE OF COPPER BASIN
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1993
Last certification
Mar 26, 2025
Beds
135
Ownership / control type
Other Nonprofit
Multi-facility organization
Twin Rivers
Most recent change of ownership
Apr 1, 2023
Organization structure
LLCProprietary
Enrollment address
166 Industrial Dr
Copperhill, TN 37317-5632
Nursing home name
DIVERSICARE OF COPPER BASIN
Affiliated entity
DIVERSICARE HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Diversicare of Copper BasinCCN 445310 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Other
Certified
Apr 1, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
13538.3 residents per day on average
Chain
Diversicare Healthcare44 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Franklin Scott Kellman Individual Corporate DirectorBoard Manager Sep 13, 2024
Brent C Fair Individual Operational/Managerial Control Apr 1, 2025
Adp of the SNF Apr 15, 2025
Stephen Michael Nee Individual Corporate OfficerChief Executive Officer Apr 1, 2025
Diversicare Management Services LP. Organization, Brentwood, TN Management services company, For-profit Operational/Managerial Control Apr 1, 2025
Eran Ratner Individual Corporate OfficerPresident Apr 1, 2025
Corporate DirectorBoard Manager/LLC Manager Apr 1, 2025
166 Industrial Drive Propco LLC Organization, Copperhill, TN LLC, For-profit Adp of the SNF Apr 1, 2025
Matthew J Weishaar Individual Corporate OfficerChief Financial Officer/Secretary Apr 1, 2025
Dac Acquisition LLC Organization, Lynbrook, NY LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2025 100%
Elias G Issa Individual Operational/Managerial Control Apr 1, 2025
Adp of the SNF Apr 11, 2025
Dac Opco, LLC Organization, Brentwood, TN LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2025 100%
Rebecca B Bodie Individual Corporate OfficerChief Operating Officer Apr 1, 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 42

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

View all 42

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": "1738022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788480000000",
    "number": "1003629809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 COOL SPRINGS BLVD STE 200",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677290",
            "telephone_number": "615-550-9453",
            "fax_number": "615-915-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 INDUSTRIAL DR",
            "city": "COPPERHILL",
            "state": "TN",
            "postal_code": "373175632",
            "telephone_number": "423-496-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAC OF COPPERHILL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-28",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A",
        "authorized_official_last_name": "WEISHAAR",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER & SECRETARY",
        "authorized_official_telephone_number": "615-771-7575"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diversicare of Copper Basin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Copperhill, TN

Sources for this page

Verify at the official NPI Registry.