NPIMap

Organization Active NPI

Hazard Nursing Home, Inc.

  • Skilled Nursing Facility
  • Hazard, KY
National Provider Identifier
1124121033
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
100462 Issued in KY
Legal business name
HAZARD NURSING HOME, INC.
Practice address
390 Park Ave.
Hazard, KY 41701
Phone
(606) 439-2306
Fax
(606) 439-2275
NPI assigned
Sep 6, 2006
Organization subpart
Yes
Parent organization
FIRST CORBIN LONG TERM CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 2008

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)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 100462 KY Primary

Addresses

Primary practice location

390 Park Ave.
Hazard, KY 41701

Mailing address

PO Box 1329
Hazard, KY 41702-1329
Phone (606) 439-2306

Other identifiers 2

IdentifierTypeStateIssuer
000000054718OtherKYANTHEM BCBS
12500179MedicaidKY

Other names 1

  • Hazard Nursing Home Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101122000178 KY Part A Provider - Skilled Nursing Facility 6709921737 Practice locations: Hazard, KY

Skilled nursing facility certification: CCN 185134

Legal name
HAZARD NURSING HOME, INC.
Doing business as
HAZARD HEALTH & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 8, 1976
Last certification
Oct 31, 2024
Beds
200
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
Dec 13, 1974 in KY
Enrollment address
390 Park Ave
Hazard, KY 41701-9548
Nursing home name
HAZARD HEALTH AND REHABILITATION CENTER
Affiliated entity
SEKY HOLDING CO.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Hazard Health and Rehabilitation CenterCCN 185134
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 8, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
200184.0 residents per day on average
Chain
Seky Holding Co.9 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 8

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

NameRoleSinceShare
Terry E Forcht Individual 5% Or Greater Indirect Ownership Interest Jun 18, 2003 98.5%
Charlotte Thornsberry Individual W-2 Managing EmployeeAdministrator Apr 1, 2011
Operational/Managerial ControlAdministrator Apr 1, 2011
Roger Alsip Individual Corporate OfficerTreasurer Aug 6, 2018
Corporate DirectorTreasurer and Director Aug 6, 2018
Fcltc Holdings Inc Organization, Corbin, KY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Apr 28, 2016 100%
David Witt Individual Corporate OfficerSecretary Aug 6, 2018
Corporate DirectorSecretary and Director Aug 6, 2018
Jackie Willis Individual Corporate OfficerAssistant Secretary Aug 6, 2018
Wesley Tipton Individual Corporate OfficerPresident/Chairman Aug 6, 2018
Corporate DirectorPresident/Chairman and Director Aug 6, 2018
Seky Holding Co Organization, Corbin, KY Corporation, For-profit 5% Or Greater Direct Ownership Interest Mar 13, 2003 100%

Facilities with the same owner 8

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

Practitioners & affiliated clinicians

Practitioners 4

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

Affiliated clinicians 6

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": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1124121033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1329",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417021329",
            "telephone_number": "606-439-2306",
            "fax_number": "606-439-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 PARK AVE.",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "41701",
            "telephone_number": "606-439-2306",
            "fax_number": "606-439-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAZARD NURSING HOME, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIRST CORBIN LONG TERM CARE, INC.",
        "enumeration_date": "2006-09-06",
        "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": "100462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000054718",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12500179",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hazard Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hazard, KY

Sources for this page

Verify at the official NPI Registry.