NPIMap

Organization Active NPI

Cumberland Family Medical Center Inc

Doing business as Taylor County Middle Healthy Kids Clinic

  • Federally Qualified Health Center (FQHC)
  • Campbellsville, KY
National Provider Identifier
1619686185
Registry record updated Aug 28, 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
Taylor County Middle Healthy Kids Clinic
Practice address
300 Ingram Ave
Campbellsville, KY 42718-1625
Phone
(844) 435-0900
Fax
(270) 858-4029
NPI assigned
Nov 23, 2022
Last updated
Aug 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 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 Primary

Addresses

Primary practice location

300 Ingram Ave
Campbellsville, KY 42718-1625

Mailing address

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

Other names 1

  • Taylor County Middle Healthy Kids Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230104000336 KY Part A Provider - Federally Qualified Health Center (FQHC) 6305947789 Practice locations: Campbellsville, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619686185. Details of each certification follow.

Federally qualified health center certification: CCN 181914

Legal name
CUMBERLAND FAMILY MEDICAL CENTER INC
Doing business as
TAYLOR COUNTY MIDDLE HEALTHY KIDS CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 5, 2022
Last certification
Dec 5, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 27, 2005 in KY
Enrollment address
300 Ingram Ave
Campbellsville, KY 42718-1625

National Provider Directory

National Provider Directory
Tax ID family
Cumberland Fam Med Ctr142 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 Dec 5, 2022
W-2 Managing EmployeeCeo Dec 5, 2022
Paula S Little Individual Corporate DirectorBoard Member Dec 5, 2022
Larry K Riddle Individual Corporate DirectorBoard Member Dec 5, 2022
Josh Hardin Individual Corporate OfficerSecretary Dec 5, 2022
Corporate DirectorSecretary/Board Member Dec 5, 2022
Elizabeth T Everley Individual Corporate DirectorBoard Member Dec 5, 2022
Lisa Tarter Individual Corporate DirectorBoard Member Dec 5, 2022
James R Flowers Individual Corporate DirectorBoard Member Dec 5, 2022
Rebecca Radford Individual Corporate DirectorBoard Member Dec 5, 2022
Terry Grider Individual Corporate DirectorBoard Member Dec 5, 2022
Bridget L Booher Individual Corporate OfficerChairperson Dec 5, 2022
Corporate DirectorChairperson/Board Member Dec 5, 2022
Garyon Scott Individual Corporate DirectorBoard Member Dec 5, 2022

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

NPI Registry JSON

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756339200000",
    "number": "1619686185",
    "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": "270-858-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 INGRAM AVE",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427181625",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND FAMILY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-23",
        "last_updated": "2025-08-28",
        "certification_date": "2022-11-23",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Taylor County Middle Healthy Kids Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Taylor County Middle Healthy Kids Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Campbellsville, KY

Sources for this page

Verify at the official NPI Registry.