Organization Active NPI

Diversicare of Amory, LLC

Doing business as Diversicare of Amory

  • Skilled Nursing Facility
  • Amory, MS
National Provider Identifier
1750836748
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
411 Issued in MS
Legal business name
DIVERSICARE OF AMORY, LLC
Doing business as
Diversicare of Amory
Practice address
1215 Earl Frye Blvd
Amory, MS 38821-5509
Phone
(662) 256-9344
Fax
(662) 256-9991
NPI assigned
Aug 18, 2016
Last updated
Sep 3, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
DIVERSICARE LEASING COMPANY III, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Authorized official

Name
Matthew J Weishaar
Title
Chief Financial Officer & Secretary
Phone
(615) 550-9459

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 411 MS Primary

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 names 1

  • Diversicare of Amory Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161011003269 MS Part A Provider - Skilled Nursing Facility 2163710997 Practice locations: Amory, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750836748. Details of each certification follow.

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
LLCProprietary
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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Diversicare of AmoryCCN 255119 · All quality measures
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
ActiveFrom the Provider of Services file
Certified beds
152110.5 residents per day on average
Chain
Diversicare Healthcare44 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D0680635Diversicare of Amory, LLC1215 Earl Frye Drive, Amory, MS 38821Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Franklin Scott Kellman Individual Corporate DirectorDirector Sep 13, 2024
Stephen Michael Nee Individual Corporate OfficerCeo Feb 20, 2023
DMS GP LLC Organization, Brentwood, TN LLC Limited Partnership Interest Apr 4, 2022 1%
Diversicare Management Services LP. Organization, Brentwood, TN Management services company, For-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2016 100%
Eran Ratner Individual Corporate OfficerPresident Sep 13, 2024
Corporate DirectorBoard Member Nov 19, 2021
Operational/Managerial ControlManaging Member Sep 13, 2024
Matthew J Weishaar Individual Corporate OfficerCfo and Secretary Dec 1, 2003
Diversicare Healthcare Services LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest May 10, 1994 100%
Dac Acquisition LLC Organization, Lynbrook, NY LLC, For-profit 5% Or Greater Indirect Ownership Interest Nov 19, 2021
Brian Kohn Individual Corporate DirectorBoard Member Nov 19, 2021
Dac Newcorp Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Apr 4, 2022 100%
Rebecca B Bodie Individual Corporate OfficerEvp and Chief Operating Officer Mar 2, 2020
Diversicare Leasing Company III LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Direct Ownership Interest Jul 1, 2016 100%
Donna S Ballard Individual Operational/Managerial ControlAdministrator of Diversicare of Oct 1, 2016
Advocat Finance, LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Jul 1, 2016 100%

Facilities with the same owner 42

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

View all 42

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 2

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": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1750836748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 COOL SPRINGS BLVD STE 200",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677290",
            "telephone_number": "615-550-9453",
            "fax_number": "615-915-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 EARL FRYE BLVD",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388215509",
            "telephone_number": "662-256-9344",
            "fax_number": "662-256-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE OF AMORY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVERSICARE LEASING COMPANY III, LLC",
        "enumeration_date": "2016-08-18",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "WEISHAAR",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER & SECRETARY",
        "authorized_official_telephone_number": "615-550-9459"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diversicare of Amory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Diversicare of Amory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Amory, MS

Sources for this page

Verify at the official NPI Registry.