NPIMap

Organization Active NPI

Cumberland Family Medical Center Inc

Doing business as Promise Community Health Center-Monticello

  • Federally Qualified Health Center (FQHC)
  • Monticello, KY
National Provider Identifier
1306519004
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CUMBERLAND FAMILY MEDICAL CENTER INC
Doing business as
Promise Community Health Center-Monticello
Practice address
1025 S Main St
Monticello, KY 42633-2762
Phone
(606) 340-8870
Fax
(606) 340-9828
NPI assigned
Jul 28, 2021
Last updated
Sep 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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
(270) 858-6655

Specialties & licenses 1

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

Addresses

Primary practice location

1025 S Main St
Monticello, KY 42633-2762

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
7100017280MedicaidKY

Other names 1

  • Promise Community Health Center-Monticello Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120221000433 KY Part B Supplier - Clinic/Group Practice 6305947789 Receives reassigned benefits from 287 practitioners
This NPI is an additional NPI on the enrollment
O20210908002795 KY Part A Provider - Federally Qualified Health Center (FQHC) 6305947789 Practice locations: Monticello, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306519004. Details of each certification follow.

Federally qualified health center certification: CCN B01022

Legal name
CUMBERLAND FAMILY MEDICAL CENTER INC
Doing business as
PROMISE COMMUNITY HEALTH CARE-MONTICELLO
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 30, 2021
Last certification
Aug 30, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 27, 2005 in KY
Enrollment address
1025 S Main St
Monticello, KY 42633-2762

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
18D2230447Promise Community Health Center-Monticello1025 S Main St, Monticello, KY 42633Provider-performed microscopyMay 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Cumberland Family Medical Inc142 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

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 OfficerCeo Jul 1, 2007
W-2 Managing EmployeeCeo Jul 1, 2007
Paula S Little Individual Corporate DirectorBoard Member Jul 1, 2007
Larry K Riddle Individual Corporate DirectorBoard Member Sep 4, 2007
Josh Hardin Individual Corporate OfficerSecretary Feb 1, 2014
Corporate DirectorSecretary Feb 1, 2014
Elizabeth T Everley Individual Corporate DirectorBoard Member Jun 19, 2012
Lisa Tarter Individual Corporate DirectorBoard Member Nov 28, 2017
James R Flowers Individual Corporate DirectorBoard Member Aug 1, 2009
Rebecca Radford Individual Corporate DirectorBoard Member Apr 19, 2016
Terry Grider Individual Corporate DirectorBoard Member Apr 19, 2016
Bridget L Booher Individual Corporate OfficerChairperson Feb 12, 2008
Corporate DirectorChairperson/Board Member Feb 12, 2008
Garyon Scott Individual Corporate DirectorBoard Member Jun 17, 2008

Owners & managing parties with NPI records 1

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

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 ClinicAlvaton, KY, CCN 181975 Federally qualified health center Operational/Managerial Control Jul 1, 2007

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1306519004",
    "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": "270-858-6655",
            "fax_number": "270-858-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S MAIN ST",
            "city": "MONTICELLO",
            "state": "KY",
            "postal_code": "426332762",
            "telephone_number": "606-340-8870",
            "fax_number": "606-340-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND FAMILY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "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": "270-858-6655",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100017280",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Promise Community Health Center-Monticello",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monticello, KY

Sources for this page

Verify at the official NPI Registry.