Diversicare of Haysville LLC
Organization Active NPI Skilled Nursing Facility · Haysville, KS
NPI 1043551815 · NPPES record last updated Sep 3, 2026
Key facts
- NPI
- 1043551815
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- DIVERSICARE OF HAYSVILLE LLC
- Practice address
- 215 N Lamar Ave
Haysville, KS 67060-1266 - Phone
- (316) 524-3211
- Fax
- (316) 524-7470
- NPI assigned
- Mar 4, 2013
- Organization subpart
- Yes
- Parent organization (as reported)
- DIVERSICARE KANSAS LLC
Authorized official
- Name
- Matthew J Weishaar
- Title
- Chief Financial Officer & Secretary
- Phone
- (615) 550-9459
Owners & managing parties with NPI records 1
-
Tamara L McCue, D.O.
Corporate family (same tax ID) 1
Facilities with the same owner 42
Practitioners 1
-
Tamara L McCue, D.O.
Affiliated clinicians 2
-
Tamara L McCue, D.O.
Medicare Care Compare: Nursing home
- Listed as
- Diversicare of Haysville
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 12, 1984
- Medicare certification status
- Active
- Certified beds
- 119 · 83.0 residents per day on average
- Chain
- Diversicare Healthcare
- Penalties (3 years)
- 3 · fines totaling $38,327
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D0451065 | Diversicare of Haysville | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Skilled nursing facility certification: CCN 175133
- Legal name
- DIVERSICARE OF HAYSVILLE LLC
- Doing business as
- DIVERSICARE OF HAYSVILLE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 12, 1984
- Last certification
- Mar 12, 2025
- Beds
- 119
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Diversicare Management Services Compan
- Most recent change of ownership
- Jan 1, 2005
- Organization structure
- LLC · Proprietary
- Incorporated
- Jan 29, 2013 in DE
- Enrollment address
- 215 N Lamar Ave
Haysville, KS 67060-1266 - Nursing home name
- DIVERSICARE OF HAYSVILLE
- Affiliated entity
- DIVERSICARE HEALTHCARE
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Franklin Scott Kellman |
Corporate Director |
Sep 13, 2024 | |
| Stephen Michael Nee |
Corporate Officer |
Feb 20, 2023 | |
| Diversicare Management Services LP. |
5% Or Greater Indirect Ownership Interest | Jan 29, 2013 | 100% |
| Operational/Managerial Control | May 1, 2013 | 100% | |
| Eran Ratner |
Corporate Officer |
Sep 13, 2024 | |
| Corporate Director |
Nov 19, 2021 | ||
| Matthew J Weishaar |
Corporate Officer |
Dec 1, 2003 | |
| Diversicare Kansas LLC |
5% Or Greater Direct Ownership Interest | Jan 29, 2013 | 100% |
| Diversicare Healthcare Services LLC |
5% Or Greater Indirect Ownership Interest | Apr 4, 2022 | 99% |
| Dac Acquisition LLC |
5% Or Greater Indirect Ownership Interest | Nov 19, 2021 | 100% |
| Brian Kohn |
Corporate Director |
Nov 19, 2021 | |
| Isaiah R. Medina |
W-2 Managing Employee |
Apr 24, 2024 | |
| Adp of the SNF | Nov 25, 2024 | ||
| Diversicare Holding Company LLC |
5% Or Greater Indirect Ownership Interest | Jan 29, 2013 | 100% |
| Tamara L McCue |
Contracted Managing Employee |
Apr 1, 2021 | |
| Adp of the SNF | Nov 25, 2024 | ||
| Dac Newcorp Inc |
5% Or Greater Indirect Ownership Interest | Apr 4, 2022 | 100% |
| Rebecca B Bodie |
Corporate Officer |
Mar 2, 2020 | |
| Advocat Finance, LLC |
5% Or Greater Indirect Ownership Interest | Jan 29, 2013 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130611000765 | KS | Part a Provider - Skilled Nursing Facility | 9830338458 | Practice locations: Haysville, KS |
National Provider Directory
- Tax ID family
- Diversicare of Haysville
Networks
- devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
215 N Lamar Ave
Haysville, KS 67060-1266
Mailing address
730 Cool Springs Blvd Ste 200
Franklin, TN 37067-7290
Phone (615) 550-9453
Other names
- Diversicare of Haysville
Other providers in Haysville, KS
- Suzanne M Compton
- Lisa Connett
- Lisa S. Crenshaw
- Amber Dejmal
- Michele Diane Delay
- Chrystal Dobrzyn
- Family Medcenters, P.a.
- Heba Safwat Bishara Ferguson
- Michael Fillmore
- Pamela Frieden
All providers in Haysville, KS · Skilled Nursing Facility in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2026. 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.