Cumberland Family Medical Center Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

CUMBERLAND FAMILY MEDICAL CENTER INC

Doing business as

Bluegrass Middle Healthy Kids Clinic

Practice address

170 W a Jenkins Rd
Elizabethtown, KY 42701-8451

Phone

(270) 765-2658

Fax

(270) 858-4029

NPI assigned

Nov 5, 2018

Last updated

Sep 18, 2025By the provider in NPPES

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

(270) 858-6655

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bluegrass Middle Healthy Kids Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407324759. Details of each certification follow.

• CCN 181120 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 181120

Legal name

BLUEGRASS MIDDLE HEALTHY KIDS CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jan 9, 2019

Last certification

Jan 9, 2019

Ownership / control type

For profit – individual

Facility address

170 W a Jenkins Road
Elizabethtown, KY 42701

Practitioners 1

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.

• Alyssa Lee Ann Cornelius, APRN

  • Family Nurse Practitioner
  • Stanford, KY
  • NPI 1992490502
  NPD

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1407324759",
    "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": "170 W A JENKINS RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427018451",
            "telephone_number": "270-765-2658",
            "fax_number": "270-858-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND FAMILY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-05",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100017280",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluegrass Middle Healthy Kids Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bluegrass Middle Healthy Kids Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Federally Qualified Health Center (FQHC) in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Federally Qualified Health Center (FQHC) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.