Cumberland Family Medical Center, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

700172 Issued in KY

Legal business name

CUMBERLAND FAMILY MEDICAL CENTER, INC.

Practice address

60 Education Way
Stanford, KY 40484-8411

Phone

(844) 435-0900

Fax

(270) 858-4029

NPI assigned

Mar 24, 2017

Organization subpart

No

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

Authorized official

Name

Eric E Loy, MD

Title

Ceo

Phone

(240) 864-1472

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Lincoln County High Healthy Kids Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 1

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

• Kimberly Dawn Phillips, APRN

  • Family Nurse Practitioner
  • Lawrenceburg, KY
  • NPI 1316387764
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490313600000",
    "number": "1174054845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6644",
            "fax_number": "270-858-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 EDUCATION WAY",
            "city": "STANFORD",
            "state": "KY",
            "postal_code": "404848411",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND FAMILY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-24",
        "last_updated": "2017-03-24",
        "status": "A",
        "authorized_official_last_name": "LOY",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-864-1472",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "KY",
            "license": "700172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "700172",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100017280",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln County High Healthy Kids Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charles Crase, MD
• Cumberland Family Medical Center Inc
• Cumberland Family Medical Center Inc
• Cumberland Family Medical Center Inc
• Cumberland Family Medical Center Inc
• Cumberland Foot and Ankle Center
• Ashley Daniels
• Gloria B Davis, MA
• Melissa F Day, PA-C
• Lindsay Joanna Degnan, COTA/L

• All providers in Stanford, KY
• Federally Qualified Health Center (FQHC) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.