Active NPI
Knott County Nursing Home, Inc.
- Skilled Nursing Facility
- Hindman, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 100495
- Legal business name
- KNOTT COUNTY NURSING HOME, INC.
- Practice address
- 388 Perkins Madden Rd
Hindman, KY 41822-9003 - Phone
- (606) 785-5011
- Fax
- (606) 785-5120
- NPI assigned
- Aug 31, 2006
- Organization subpart
- Yes
- Parent organization
- FIRST CORBIN LONG TERM CARE, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Terry Emanuel Forcht
- Title
- Chairman
- Phone
- (606) 528-9600
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 100495 | KY | Primary |
Addresses
Primary practice location
388 Perkins Madden Rd
Hindman, KY 41822-9003
Mailing address
388 Perkins Madden Rd
Hindman, KY 41822-9003
Phone (606) 785-5011
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000054828 | Other | KY | ANTHEM BCBS |
| 037415900 | Other | FEDERAL BLACK LUNG | |
| 12501052 | Medicaid | KY |
Other names 1
- Knott County Nursing Home
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20020913000007 | KY | Part A Provider - Skilled Nursing Facility | 0749197564 | Practice locations: Hindman, KY |
Skilled nursing facility certification: CCN 185150
- Legal name
- KNOTT COUNTY NURSING HOME, INC.
- Doing business as
- KNOTT COUNTY HEALTH & REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 22, 1978
- Last certification
- Nov 8, 2024
- Beds
- 92
- Ownership / control type
- Individual
- Organization structure
- Corporation
- Incorporated
- Jan 2, 1986 in KY
- Enrollment address
- 388 Perkins Madden Rd
Hindman, KY 41822-9003 - Nursing home name
- KNOTT COUNTY HEALTH & REHABILITATION CENTER
- Affiliated entity
- SEKY HOLDING CO.
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Knott County Health & Rehabilitation Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Individual
- Certified
- Jun 22, 1978
- Medicare certification status
- Active
- Certified beds
- 92
- Chain
- Seky Holding Co.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D0648610 | Knott County Health & Rehab Center | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 9
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 |
|---|---|---|---|
| John Dailey | Operational/Managerial Control | May 16, 2018 | |
| Jessica Hall | W-2 Managing Employee | Jan 25, 2022 | |
| Operational/Managerial Control | Jan 25, 2022 | ||
| Roger Alsip | Corporate Officer | Jan 1, 2011 | |
| Corporate Director | Aug 6, 2018 | ||
| Christopher Warren Stumbo | Contracted Managing Employee | Feb 1, 2024 | |
| David Witt | Corporate Officer | Jun 21, 2011 | |
| Corporate Director | Aug 6, 2018 | ||
| Jackie Willis | Corporate Officer | Jan 1, 2011 | |
| Wesley Tipton | Corporate Officer | May 16, 2018 | |
| Corporate Director | Jun 20, 2016 | ||
| Seky Holding Co | 5% Or Greater Direct Ownership Interest | Mar 13, 2003 | 100% |
| Susan Arnold | Corporate Director | Jan 1, 2011 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Hazard, KY
- NPI 1962962548
Contracted Managing Employee
Facilities with the same owner 8
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Barbourville, KY
- NPI 1578675963
Seky Holding Co
-
- Skilled Nursing Facility
- Corbin, KY
- NPI 1962514380
Seky Holding Co
-
- Skilled Nursing Facility
- Williamsburg, KY
- NPI 1750493151
Seky Holding Co
-
- Skilled Nursing Facility
- Campton, KY
- NPI 1922101815
Seky Holding Co
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Hindman, KY
- NPI 1518587427
-
- Family Medicine Physician
- Hazard, KY
- NPI 1962962548
-
- Family Medicine Physician
- Hindman, KY
- NPI 1336274596
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": "1156982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1210118400000",
"number": "1003928482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "388 PERKINS MADDEN RD",
"city": "HINDMAN",
"state": "KY",
"postal_code": "418229003",
"telephone_number": "606-785-5011",
"fax_number": "606-785-5120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "388 PERKINS MADDEN RD",
"city": "HINDMAN",
"state": "KY",
"postal_code": "418229003",
"telephone_number": "606-785-5011",
"fax_number": "606-785-5120"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KNOTT COUNTY NURSING HOME, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FIRST CORBIN LONG TERM CARE, INC.",
"enumeration_date": "2006-08-31",
"last_updated": "2008-05-07",
"status": "A",
"authorized_official_last_name": "FORCHT",
"authorized_official_first_name": "TERRY",
"authorized_official_middle_name": "EMANUEL",
"authorized_official_title_or_position": "CHAIRMAN",
"authorized_official_telephone_number": "606-528-9600",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "KY",
"license": "100495",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000054828",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL BLACK LUNG",
"identifier": "037415900",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "12501052",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Knott County Nursing Home",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Hindman, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.