Cumberland Family Medical Center Inc

Organization Active NPI Federally Qualified Health Center (FQHC) · Bowling Green, KY

NPI 1023735545 · NPPES record last updated Sep 4, 2025

Key facts

NPI
1023735545
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
CUMBERLAND FAMILY MEDICAL CENTER INC
Practice address
2617 Russellville Road
Bowling Green, KY 42101-3926
Phone
(844) 435-0900
Fax
(270) 858-4029
NPI assigned
Oct 25, 2022
Organization subpart
No

Authorized official

Name
Eric E Loy, MD
Title
Ceo
Phone
(270) 858-6655

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Corporate family (same tax ID) 19

Organizations that report the same tax identification number in the National Provider Directory.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY

Federally qualified health center certification: CCN B01068

Legal name
CUMBERLAND FAMILY MEDICAL CENTER INC
Doing business as
JENNINGS CREEK ELEMENTARY HEALTHY KIDS CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 27, 2023
Last certification
Feb 27, 2023
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Jun 27, 2005 in KY
Enrollment address
2617 Russellville Rd
Bowling Green, KY 42101-3926

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Eric E Loy
Individual
Corporate Officer
Ceo
Jul 1, 2007
W-2 Managing Employee
Ceo
Jul 1, 2007
Paula S Little
Individual
Corporate Director
Board Member
Jul 1, 2007
Larry K Riddle
Individual
Corporate Director
Board Member
Sep 4, 2007
Josh Hardin
Individual
Corporate Officer
Secretary
Feb 1, 2014
Corporate Director
Board Member
Feb 1, 2014
Elizabeth T Everley
Individual
Corporate Director
Board Member
Jun 19, 2012
Lisa Tarter
Individual
Corporate Director
Board Member
Nov 28, 2017
James R Flowers
Individual
Corporate Director
Board Member
Aug 1, 2009
Rebecca Radford
Individual
Corporate Director
Board Member
Apr 19, 2016
Terry Grider
Individual
Corporate Director
Board Member
Apr 19, 2016
Bridget L Booher
Individual
Corporate Officer
Chairperson
Feb 12, 2008
Corporate Director
Board Member
Feb 12, 2008
Garyon Scott
Individual
Corporate Director
Board Member
Jun 17, 2008

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Alavaton Elementary Healthy Kids Clinic
Alvaton, KY · CCN 181975
Federally qualified health center Operational/Managerial Control Jul 1, 2007

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230428000312 KY Part a Provider - Federally Qualified Health Center (FQHC) 6305947789 Practice locations: Bowling Green, KY

National Provider Directory

Tax ID family
Cumberland Fam Med Ctr (141 organizations share this tax ID)

Locations

2617 Russellville Rd
Bowling Green, KY 42101
Phone (270) 904-9200

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

2617 Russellville Road
Bowling Green, KY 42101-3926

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 858-6655

Other identifiers

IdentifierTypeStateIssuer
7100017280MedicaidKY

Other names

  • Jennings Creek Elementary Healthy Kids Clinic Doing business as

Other providers in Bowling Green, KY

All providers in Bowling Green, KY · Federally Qualified Health Center (FQHC) in Kentucky

Sources for this page

Verify at the official NPI Registry.