DIVERSICARE OF SHELBY
NPI 1497405328
Skilled Nursing Facility in Shelby, MS

Active since March 24, 2022CLIA 25D0669514 · Waiver
4/5
Overall Rating
1108 CHURCH ST, SHELBY, MS 38774(662) 846-2590(662) 398-7766 Get Directions Write a Review

NPPES record last updated: April 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Diversicare Of Shelby NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIVERSICARE OF SHELBY (NPI 1497405328) is a healthcare organization registered as a skilled nursing facility in Shelby, Mississippi and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Matthew J. Weishaar, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1497405328
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameDAC OF SHELBY, LLC
Location Address1108 CHURCH STShelby, MS 38774-2200
Mailing Address1621 Galleria BlvdBrentwood, TN 37027-2926 · (615) 550-9400 · Fax (615) 620-7875
Fax(662) 398-7766
Organization SubpartYesParent: Dac Acquisition Llc
Authorized OfficialMatthew J. WeishaarChief Financial Officer · (615) 550-9459
Enumeration DateMarch 24, 2022
Last NPPES UpdateApril 7, 2023
NPPES CertifiedApril 7, 2023
NPI 1497405328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
1108 CHURCH ST, Shelby, MS 38774

Other Names 1

Doing Business AsDiversicare Of Shelby

Other Identifiers 1

Other25-5293MS · Medicare - Snf

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D0669514

Diversicare Of Shelby · Shelby, MS
Active · expires Aug 31, 2026
CLIA Number25D0669514
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorZina Christian
Laboratory Phone(662) 398-5117
Laboratory LocationDiversicare Of Shelby1108 Church Street, Shelby, MS 38774
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Diversicare Of Shelby (CMS certification number 255293), from CMS Care Compare.

Diversicare Of Shelby

Nursing home · Shelby, MS
4/5 CMS Overall Rating
OwnershipFor profit - Corporation
CMS Certification Number255293
Certified Beds60 beds54 residents per day on average
Medicare & Medicaid Participant SinceJanuary 1, 2003
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
2/5
Long-Stay Quality
Quality of care delivered to long-term residents.
1/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
2/5
Staffing
Based on nursing staff hours relative to resident needs.
4/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
17.33
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 1.92 · LPN 0.66 · RN 0.7
3.28 hrs per resident per day
Weekend Nurse Staffing
2.87 hrs per resident per day
Physical Therapist Staffing
0.01 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
32.5%
Registered Nurse Turnover
37.5%
Administrators Who Have Left
In the past year.
0
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
0
Fines
0
Medicare Payment Denials
0
Total Penalties
0
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
1108 CHURCH ST
SHELBY, MS 38774
Skilled Nursing Facility
1108 CHURCH ST
SHELBY, MS 38774
Occupational Therapist
1108 CHURCH ST
SHELBY, MS 38774

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dac Of Shelby, LLC's NPI number?

The NPI number for Dac Of Shelby, LLC is 1497405328. It was assigned to this organization in the NPPES registry on March 24, 2022. The provider is doing business as Diversicare Of Shelby.

Where is Dac Of Shelby, LLC located?

Dac Of Shelby, LLC is located at 1108 Church St, Shelby, MS 38774. The listed phone number is (662) 846-2590.

What is Dac Of Shelby, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Dac Of Shelby, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D0669514) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Dac Of Shelby, LLC a Medicare-certified nursing home?

Yes. Diversicare Of Shelby is a Medicare-certified nursing home with 60 certified beds.

What quality rating does Dac Of Shelby, LLC have?

CMS rates Diversicare Of Shelby 4 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Dac Of Shelby, LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 3 other insurers list Dac Of Shelby, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dac Of Shelby, LLC was last updated on April 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.