Cumberland Family Medical Center, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

CUMBERLAND FAMILY MEDICAL CENTER, INC.

Practice address

10739 S US 127
Ste 1
Dunnville, KY 42528-6037

Phone

(833) 238-1214

Fax

(270) 858-4607

NPI assigned

Apr 11, 2019

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

• My Lyfe Dunnville Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Federally qualified health center certification: CCN 181141

Legal name

MY LYFE DUNNVILLE

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

May 20, 2019

Last certification

May 20, 2019

Ownership / control type

For profit – partnership

Facility address

10739 S US 127, Suite 1
Dunnville, KY 42528

Practitioners 1

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

• Nicole L Loy, APRN

  • Family Nurse Practitioner
  • Columbia, KY
  • NPI 1124537501
  NPD

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1760945208",
    "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": "10739 S US 127",
            "address_2": "STE 1",
            "city": "DUNNVILLE",
            "state": "KY",
            "postal_code": "425286037",
            "telephone_number": "833-238-1214",
            "fax_number": "270-858-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND FAMILY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-11",
        "last_updated": "2019-04-11",
        "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": "My Lyfe Dunnville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alternative Health Solutions LLC
• Cassidy Emerson, MSN, APRN, FNP-C
• Jennifer Lucille Rogers, APRN, FNP-BC
• Carol Jean Swartz, APRN

• Federally Qualified Health Center (FQHC) in Dunnville, KY
• Providers in Dunnville, 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 Apr 11, 2019; 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.