Cumberland Family Medical Center Inc

Organization Active NPI Federally Qualified Health Center (FQHC) · Jamestown, KY

NPI 1972862407 · NPPES record last updated Sep 3, 2025

Key facts

NPI
1972862407
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
CUMBERLAND FAMILY MEDICAL CENTER INC
Practice address
1417 N Main Street
Jamestown, KY 42629-0966
Phone
(270) 343-2597
Fax
(270) 343-2598
NPI assigned
May 3, 2012
Organization subpart
No

Authorized official

Name
Dr. Eric E Loy, MD
Title
Ceo
Phone
(270) 858-6655

Owners & managing parties with NPI records 1

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

Corporate family (same tax ID) 14

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 6

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in KY

Federally qualified health center certification: CCN 181904

Legal name
CUMBERLAND FAMILY MEDICAL CENTER INC
Doing business as
JAMESTOWN FAMILY MEDICAL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 29, 2013
Last certification
Mar 29, 2013
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Apr 23, 2007 in KY
Enrollment address
1417 N Main St
Jamestown, KY 42629-2411

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 Officer
Ceo
Jul 1, 2007
Corporate Director
Ceo
Jul 1, 2007
W-2 Managing Employee
Ceo
Jul 1, 2007
Paula S Little
Individual
Corporate Director
Board Member
Dec 16, 2012
Larry K Riddle
Individual
Corporate Director
Board Member
Sep 4, 2007
Josh Hardin
Individual
Corporate Officer
Secretary
Feb 1, 2014
Corporate Director
Secretary/Board Member
Feb 1, 2014
Melvin L Groce
Individual
Corporate Officer
Treasurer
Sep 4, 2007
Corporate Director
Treasurer/Board Member
Sep 4, 2007
Elizabeth T Everley
Individual
Corporate Director
Board Member
Dec 16, 2012
James R Flowers
Individual
Corporate Director
Board Member
Aug 1, 2009
Rebecca Radford
Individual
Corporate Director
Board Member
Apr 19, 2016
Terry Grider
Individual
Corporate Director
Board Member
Apr 19, 2016
Bridget L Booher
Individual
Corporate Officer
Chairperson
Dec 16, 2012
Corporate Director
Chairperson/Board Member
Dec 16, 2012
Garyon Scott
Individual
Corporate Director
Board Member
Jun 17, 2008

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 Clinic
Alvaton, KY · CCN 181975
Federally qualified health center Operational/Managerial Control Jul 1, 2007

Medicare enrollment records

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
O20130329000070 KY Part a Provider - Federally Qualified Health Center (FQHC) 6305947789 Practice locations: Jamestown, KY

National Provider Directory

Tax ID family
Cumberland Fam Med Ctr (141 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X KY Yes

Addresses

Primary practice location

1417 N Main Street
Jamestown, KY 42629-0966

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 343-2597

Other identifiers

IdentifierTypeStateIssuer
7100017280MedicaidKY

Other names

  • Jamestown Family Medical Center Doing business as

Other providers in Jamestown, KY

All providers in Jamestown, KY · Federally Qualified Health Center (FQHC) in Kentucky

Sources for this page

Verify at the official NPI Registry.