NPIMap

Organization Active NPI

KDM Inc

Doing business as Durham-Hensley Health and Rehabilitation

  • Skilled Nursing Facility
  • Chuckey, TN
National Provider Identifier
1124080221
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0000000310 Issued in TN
Legal business name
KDM INC
Doing business as
Durham-Hensley Health and Rehabilitation
Practice address
55 Nursing Home Rd
Chuckey, TN 37641
Phone
(423) 257-6761
Fax
(423) 257-4936
NPI assigned
Apr 4, 2006
Last updated
Mar 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
Kathie H Ball
Title
President
Phone
(423) 257-6761

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 0000000310 TN
Skilled Nursing Facility 314000000X 0000000310 TN Primary

Addresses

Primary practice location

55 Nursing Home Rd
Chuckey, TN 37641

Mailing address

55 Nursing Home Rd
Chuckey, TN 37641
Phone (423) 257-6761

Other identifiers 2

IdentifierTypeStateIssuer
0445478MedicaidTN
7440366MedicaidTN

Other names 1

  • Durham-Hensley Health and Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040929000017 TN Part A Provider - Skilled Nursing Facility 8527037324 Practice locations: Chuckey, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124080221. Details of each certification follow.

Skilled nursing facility certification: CCN 445478

Legal name
KDM INC
Doing business as
DURHAM-HENSLEY HEALTH AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 22, 2005
Last certification
Aug 23, 2023
Beds
75
Ownership / control type
Individual
Organization structure
CorporationProprietary
Incorporated
Nov 20, 1992 in TN
Enrollment address
55 Nursing Home Rd
Chuckey, TN 37641-5579
Nursing home name
DURHAM-HENSLEY HEALTH AND REHABILITATION

Care Compare: Nursing home

Medicare Care Compare
Listed as
Durham-Hensley Health and RehabilitationCCN 445478 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 22, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7562.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Donna Blazer Individual 5% Or Greater Direct Ownership Interest Nov 20, 1992 36.75%
Corporate OfficerSecretary Nov 20, 1992
Corporate DirectorSecretary, Board Member Nov 20, 1992
Operational/Managerial ControlSecretary, Board Member Nov 20, 1992
Diana Heath Individual W-2 Managing EmployeeDirector of Nursing Jun 1, 2014
Tammy Sowers Individual W-2 Managing Employee May 1, 2020
Care Centers Management Consulting, Inc. Organization, Johnson City, TN Corporation Operational/Managerial Control Oct 1, 2004
Kathie Ball Individual 5% Or Greater Direct Ownership Interest Nov 20, 1992 63.25%
Corporate OfficerPresident Nov 20, 1992
Corporate DirectorPresident, Board Member Nov 20, 1992
W-2 Managing EmployeeFacility Administrator Nov 20, 1992
Operational/Managerial ControlPresident, Board Member, Facilit Nov 20, 1992

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Practitioners 2

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 1

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": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1124080221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NURSING HOME RD",
            "city": "CHUCKEY",
            "state": "TN",
            "postal_code": "37641",
            "telephone_number": "423-257-6761",
            "fax_number": "423-257-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 NURSING HOME RD",
            "city": "CHUCKEY",
            "state": "TN",
            "postal_code": "37641",
            "telephone_number": "423-257-6761",
            "fax_number": "423-257-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KDM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "BALL",
        "authorized_official_first_name": "KATHIE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-257-6761"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "0000000310",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TN",
            "license": "0000000310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445478",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440366",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Durham-Hensley Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chuckey, TN

Sources for this page

Verify at the official NPI Registry.