NPIMap

Organization Active NPI

KDM Inc

  • 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
Practice address
55 Nursing Home Rd
Chuckey, TN 37641
Phone
(423) 257-6761
Fax
(423) 257-4936
NPI assigned
Apr 4, 2006
Organization subpart
No

Authorized official

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

Facilities with the same owner 5

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

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Durham-Hensley Health and RehabilitationCCN 445478
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.

Medicare participation

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

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

Enrollment records 1

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

All disclosed owners & managing parties 5

Medicare enrollment files

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

National Provider Directory

National Provider Directory

Specialties & licenses 2

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

Addresses

NPPES NPI Registry

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

NPPES NPI Registry
IdentifierTypeStateIssuer
7440366MedicaidTN
0445478MedicaidTN

Other names 1

NPPES NPI Registry
  • Durham-Hensley Health and Rehabilitation Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 6, 2008.

{
    "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": "7440366",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445478",
            "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.