Diversicare of Amory, LLC
Organization Active NPI Skilled Nursing Facility · Amory, MS
NPI 1750836748 · NPPES record last updated Sep 3, 2026
Key facts
- NPI
- 1750836748
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 411 (MS)
- Legal business name
- DIVERSICARE OF AMORY, LLC
- Practice address
- 1215 Earl Frye Blvd
Amory, MS 38821-5509 - Phone
- (662) 256-9344
- Fax
- (662) 256-9991
- NPI assigned
- Aug 18, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- DIVERSICARE LEASING COMPANY III, LLC
Authorized official
- Name
- Matthew J Weishaar
- Title
- Chief Financial Officer & Secretary
- Phone
- (615) 550-9459
Facilities with the same owner 42
Practitioners 2
-
Troy Jun Ostrander, D.O.
Affiliated clinicians 2
-
Troy Jun Ostrander, D.O.
Medicare Care Compare: Nursing home
- Listed as
- Diversicare of Amory
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 1, 1989
- Medicare certification status
- Active
- Certified beds
- 152 · 110.5 residents per day on average
- Chain
- Diversicare Healthcare
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D0680635 | Diversicare of Amory, LLC | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Skilled nursing facility certification: CCN 255119
- Legal name
- DIVERSICARE OF AMORY LLC
- Doing business as
- DIVERSICARE OF AMORY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 1, 1989
- Last certification
- Feb 13, 2025
- Beds
- 152
- Ownership / control type
- Corporation
- Multi-facility organization
- Diversicare
- Organization structure
- LLC · Proprietary
- Incorporated
- Jul 1, 2016 in DE
- Enrollment address
- 1215 Earl Frye Blvd
Amory, MS 38821-5509 - Nursing home name
- DIVERSICARE OF AMORY
- Affiliated entity
- DIVERSICARE HEALTHCARE
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Franklin Scott Kellman |
Corporate Director |
Sep 13, 2024 | |
| Stephen Michael Nee |
Corporate Officer |
Feb 20, 2023 | |
| DMS GP LLC |
Limited Partnership Interest | Apr 4, 2022 | 1% |
| Diversicare Management Services LP. |
5% Or Greater Indirect Ownership Interest | Jul 1, 2016 | 100% |
| Eran Ratner |
Corporate Officer |
Sep 13, 2024 | |
| Corporate Director |
Nov 19, 2021 | ||
| Operational/Managerial Control |
Sep 13, 2024 | ||
| Matthew J Weishaar |
Corporate Officer |
Dec 1, 2003 | |
| Diversicare Healthcare Services LLC |
5% Or Greater Indirect Ownership Interest | May 10, 1994 | 100% |
| Dac Acquisition LLC |
5% Or Greater Indirect Ownership Interest | Nov 19, 2021 | |
| Brian Kohn |
Corporate Director |
Nov 19, 2021 | |
| Dac Newcorp Inc |
5% Or Greater Indirect Ownership Interest | Apr 4, 2022 | 100% |
| Rebecca B Bodie |
Corporate Officer |
Mar 2, 2020 | |
| Diversicare Leasing Company III LLC |
5% Or Greater Direct Ownership Interest | Jul 1, 2016 | 100% |
| Donna S Ballard |
Operational/Managerial Control |
Oct 1, 2016 | |
| Advocat Finance, LLC |
5% Or Greater Indirect Ownership Interest | Jul 1, 2016 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161011003269 | MS | Part a Provider - Skilled Nursing Facility | 2163710997 | Practice locations: Amory, MS |
National Provider Directory
Locations
1215 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-4640
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 411 | MS | Yes |
Addresses
Primary practice location
1215 Earl Frye Blvd
Amory, MS 38821-5509
Mailing address
730 Cool Springs Blvd Ste 200
Franklin, TN 37067-7290
Phone (615) 550-9453
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00023006 | Medicaid | MS |
Other names
- Diversicare of Amory
Other providers in Amory, MS
- Curries Family Care Pharmacy of Amory, LLC
- Kelly Coker Dabbs
- Robert A Dale Jr.
- Jamie Suzanne Davis
- Melinda Dickerson
- Drayer Physical Therapy Institute LLC
- Drayer Physical Therapy Mississippi LLC
- DVC Pharmacy LLC
- East Amory Elementary School
- Daniel Murry Eddings
All providers in Amory, MS · Skilled Nursing Facility in Mississippi
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.