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  5. LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C.

LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C.

Company Details

Name: LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C.
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Professional Services Corp
Status: Active
Standing: Good
File Date: 28 Jun 1979 (46 years ago)
Organization Date: 28 Jun 1979 (46 years ago)
Last Annual Report: 28 Feb 2024 (a year ago)
Organization Number: 0118930
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 40258
Primary County: Jefferson
Principal Office: 6801 DIXIE HIGHWAY, STE 127, LOUISVILLE, KY 40258
Place of Formation: KENTUCKY
Authorized Shares: 2000

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LOUISVILLE PEDIATRIC SPECIALISTS, PSC PROFIT SHARING AND 401(K) PLAN 2023 610956698 2024-07-30 LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C. 21
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951
LOUISVILLE PEDIATRIC SPECIALISTS, PSC PROFIT SHARING AND 401(K) PLAN 2022 610956698 2023-10-10 LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C. 21
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951
LOUISVILLE PEDIATRIC SPECIALISTS, PSC PROFIT SHARING AND 401(K) PLAN 2021 610956698 2022-10-04 LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C. 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951
LOUISVILLE PEDIATRIC SPECIALISTS, PSC PROFIT SHARING AND 401(K) PLAN 2020 610956698 2021-09-15 LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951
LOUISVILLE PEDIATRIC SPECIALISTS, PSC PROFIT SHARING AND 401(K) PLAN 2019 610956698 2020-04-28 LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C. 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951
LOUISVILLE PEDIATRIC SPECIALISTS, PSC PROFIT SHARING AND 401(K) PLAN 2018 610956698 2019-04-17 LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C. 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951
LOUISVILLE PEDIATRIC SPECIALISTS, PSC PROFIT SHARING AND 401(K) PLAN 2017 610956698 2018-04-10 LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C. 21
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951
LOUISVILLE PEDIATRIC SPECIALISTS, PSC PROFIT SHARING AND 401(K) PLAN 2016 610956698 2017-05-01 LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C. 21
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951

Signature of
Role Plan administrator
Date 2017-05-01
Name of individual signing PAUL D. DIEBOLD, M.D.
Valid signature Filed with authorized/valid electronic signature
LOUISVILLE PEDIATRIC SPECIALISTS, PSC PROFIT SHARING AND 401(K) PLAN 2015 610956698 2016-07-26 LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C. 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951

Signature of
Role Plan administrator
Date 2016-07-26
Name of individual signing PAUL D. DIEBOLD, M.D.
Valid signature Filed with authorized/valid electronic signature
LOUISVILLE PEDIATRIC SPECIALISTS, PSC PROFIT SHARING AND 401(K) PLAN 2014 610956698 2015-09-15 LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951

Signature of
Role Plan administrator
Date 2015-09-15
Name of individual signing PAUL D. DIEBOLD, M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/03/20140703090421P030008777021001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951

Signature of
Role Plan administrator
Date 2014-07-03
Name of individual signing PAUL D. DIEBOLD, M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/18/20130718103036P030111616581001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951

Signature of
Role Plan administrator
Date 2013-07-18
Name of individual signing PAUL D. DIEBOLD, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-18
Name of individual signing PAUL D. DIEBOLD, M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/11/29/20121129085648P030048878882001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951

Plan administrator’s name and address
Administrator’s EIN 610956698
Plan administrator’s name LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C.
Plan administrator’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951
Administrator’s telephone number 5029355633

Signature of
Role Plan administrator
Date 2012-11-29
Name of individual signing PAUL D. DIEBOLD, M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/01/18/20120118133905P030005970839001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951

Plan administrator’s name and address
Administrator’s EIN 610956698
Plan administrator’s name LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C.
Plan administrator’s address 6801 DIXIE HIGHWAY, SUITE 127, LOUISVILLE, KY, 402583951
Administrator’s telephone number 5029355633

Signature of
Role Plan administrator
Date 2012-01-18
Name of individual signing PAUL D. DIEBOLD, M.D.
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address P.O. BOX 58218, LOUISVILLE, KY, 402680218

Plan administrator’s name and address
Administrator’s EIN 610956698
Plan administrator’s name LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C.
Plan administrator’s address P.O. BOX 58218, LOUISVILLE, KY, 402680218
Administrator’s telephone number 5029355633

Signature of
Role Plan administrator
Date 2011-03-07
Name of individual signing PAUL D. DIEBOLD MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/01/10/20120110135924P040004723303001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1979-07-01
Business code 621111
Sponsor’s telephone number 5029355633
Plan sponsor’s address P.O. BOX 58218, LOUISVILLE, KY, 402680218

Plan administrator’s name and address
Administrator’s EIN 610956698
Plan administrator’s name LOUISVILLE PEDIATRIC SPECIALISTS, P.S.C.
Plan administrator’s address P.O. BOX 58218, LOUISVILLE, KY, 402680218
Administrator’s telephone number 5029355633

Signature of
Role Plan administrator
Date 2012-01-10
Name of individual signing PAUL D. DIEBOLD, M.D.
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
THOMAS C HUBBS Registered Agent

Director

Name Role
JOHN W KIM Director
TRACEE L WOJTKOWSKI Director
ROBERT M. SENESE, M.D. Director
JOSEPH C. BABEY, M.D. Director
HENRY F. DELONG, M.D. Director
THOMAS C HUBBS Director

Shareholder

Name Role
THOMAS C HUBBS Shareholder
JOHN W KIM Shareholder
TRACEE L WOJTKOWSKI Shareholder

Incorporator

Name Role
JOSEPH C. BABEY, M.D. Incorporator
HENRY F. DELONG, M.D. Incorporator
ROBERT M. SENESE, M.D. Incorporator

Vice President

Name Role
JOHN W KIM Vice President
TRACEE L WOJTKOWSKI Vice President

President

Name Role
THOMAS C HUBBS President

Filings

Name File Date
Registered Agent name/address change 2024-02-28
Principal Office Address Change 2024-02-28
Annual Report 2024-02-28
Annual Report 2023-03-15
Principal Office Address Change 2023-03-15
Annual Report 2022-05-09
Registered Agent name/address change 2021-02-09
Annual Report 2021-02-09
Annual Report 2020-02-26
Annual Report 2019-04-22

Related by officers

JOSEPH C. BABEY, M.D.

SOUTH JEFFERSON COUNTY MEDIGROUP, INC.

HENRY F. DELONG, M.D.

SOUTH JEFFERSON COUNTY MEDIGROUP, INC.

Related by address

No related companies by address

Date of last update: 28 Jan 2025

Sources: Kentucky Secretary of State

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