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I suspect "First" is just a name that local churches have chosen. If you are the first United Methodist Church in your city, you might call yourself "First United Methodist Church of ..." Our church is called "Sparks United Methodist Church." We are the only United Methodist Church in Sparks, Nevada, though there are three more across the river in Reno, including "Reno First United Methodist Church."
Could be...but I always thought it was the rarity to be called something else. I feel like the majority off United Methodist churches are FUMCs, at least in my experience.
I used to belong to the First Methodist Church of West Union, Iowa. We were just "Methodists" then. We then joined with another denomination (United Brethren?) and became "United Methodists."