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CENTRAL KENTUCKY SURGEONS, P.S.C.

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Company Details

Name: CENTRAL KENTUCKY SURGEONS, P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 06 Oct 1969 (56 years ago)
Organization Date: 06 Oct 1969 (56 years ago)
Last Annual Report: 18 Feb 2025 (7 months ago)
Organization Number: 0150123
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 40422
City: Danville
Primary County: Boyle County
Principal Office: 130 DANIEL DRIVE, DANVILLE, KY 40422
Place of Formation: KENTUCKY
Authorized Shares: 100

Registered Agent

Name Role
David O. Montgomery M.D. Registered Agent

Vice President

Name Role
KATRINA A KOLASA Vice President

Shareholder

Name Role
DAVID O MONTGOMERY Shareholder
KATRINA A KOLASA Shareholder
GEORGE S MUNDAY Shareholder

President

Name Role
DAVID O MONTGOMERY President

Director

Name Role
K. B. DANIEL JR. M. D. Director
CHRIS JACKSON JR. M. D. Director

Incorporator

Name Role
K. B. DANIEL JR. M. D. Incorporator
CHRIS JACKSON JR. M. D. Incorporator

Secretary

Name Role
GEORGE S MUNDAY Secretary

National Provider Identifier

NPI Number:
1114079555

Authorized Person:

Name:
DR. JOHN H. LACY
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
363AM0700X - Medical Physician Assistant
Is Primary:
No
Selected Taxonomy:
208600000X - Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
8592362227

Form 5500 Series

Employer Identification Number (EIN):
610703252
Plan Year:
2022
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
3
Sponsors Telephone Number:

Former Company Names

Name Action
JACKSON & LACY, P. S. C. Old Name
JACKSON, CODY & LACY, P. S.C. Old Name
DANIEL, JACKSON & CODY, P.S.C. Old Name
DANIEL AND JACKSON, P. S. C. Old Name

Filings

Name File Date
Annual Report 2025-02-18
Annual Report 2024-03-19
Registered Agent name/address change 2024-03-19
Annual Report 2023-03-17
Annual Report 2022-03-14

USAspending Awards / Financial Assistance

Date:
2020-04-11
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
154100.00
Total Face Value Of Loan:
154100.00

OSHA's Inspections within Industry

Inspection Summary

Date:
2002-12-03
Type:
Complaint
Address:
130 DANIEL DRIVE, DANVILLE, KY, 40422
Safety Health:
Health
Scope:
Partial

Paycheck Protection Program

Jobs Reported:
5
Initial Approval Amount:
$154,100
Date Approved:
2020-04-10
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$154,100
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Unanswered
Forgiveness Amount:
$155,812.22
Servicing Lender:
The Farmers National Bank of Danville
Use of Proceeds:
Payroll: $154,100
Jobs Reported:
6
Initial Approval Amount:
$154,100
Date Approved:
2021-02-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$154,100
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Unanswered
Forgiveness Amount:
$155,204.38
Servicing Lender:
The Farmers National Bank of Danville
Use of Proceeds:
Payroll: $154,099

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Sources: Kentucky Secretary of State