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SOUTHERN EMERGENCY MEDICAL SPECIALISTS, P.S.C.

Company Details

Name: SOUTHERN EMERGENCY MEDICAL SPECIALISTS, P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 11 Dec 1985 (39 years ago)
Organization Date: 11 Dec 1985 (39 years ago)
Last Annual Report: 27 Jun 2024 (a year ago)
Organization Number: 0209226
Industry: Health Services
Number of Employees: Medium (20-99)
Principal Office: P O BOX 36218, LOUISVILLE, KY 402336218
Place of Formation: KENTUCKY
Authorized Shares: 10000

Shareholder

Name Role
JESSICA KOTHA Shareholder
R. DOUGLAS KELLY Shareholder
JAMES COULSON GRAY, IV Shareholder
JEFFERY MCAFEE Shareholder
JEFF SPAIN Shareholder
SHANNON BECHT Shareholder
THEODORE FORREST Shareholder
ANDREW ROCHET Shareholder
RICHARD CARLISLE Shareholder
LAURA GILBERT Shareholder

Director

Name Role
R DOUGLAS KELLY Director
ROBERT COUCH, M.D. Director
SHANNON BECHT Director
JEFFERY MCAFEE Director
ANDREW ROCHET Director
STEPHEN RICHARDS Director
MATTHEW ALLINDER Director
ASAD JAVED Director

Incorporator

Name Role
ROBERT COUCH, M.D. Incorporator

Registered Agent

Name Role
Jeffery L. McAfee, MD Registered Agent

President

Name Role
JEFFERY MCAFEE President

Secretary

Name Role
ANDREW ROCHET Secretary

Treasurer

Name Role
ANDREW ROCHET Treasurer

Vice President

Name Role
SHANNON BECHT Vice President

National Provider Identifier

NPI Number:
1194704866
Certification Date:
2022-07-06

Authorized Person:

Name:
MS. DEBBIE A OSBORNE
Role:
CREDENTIALING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
363AM0700X - Medical Physician Assistant
Is Primary:
No
Selected Taxonomy:
363AS0400X - Surgical Physician Assistant
Is Primary:
No
Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LA2100X - Acute Care Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207PP0204X - Pediatric Emergency Medicine (Emergency Medicine) Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
390200000X - Student in an Organized Health Care Education/Training Program
Is Primary:
No
Selected Taxonomy:
207P00000X - Emergency Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
5026346775

Form 5500 Series

Employer Identification Number (EIN):
611087711
Plan Year:
2023
Number Of Participants:
101
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
97
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
100
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
102
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
102
Sponsors Telephone Number:

Filings

Name File Date
Registered Agent name/address change 2024-06-27
Annual Report 2024-06-27
Annual Report 2023-06-22
Annual Report 2022-05-16
Annual Report 2021-06-09

USAspending Awards / Financial Assistance

Date:
2020-04-15
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:
1799800.00
Total Face Value Of Loan:
1799800.00

Paycheck Protection Program

Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
1799800
Current Approval Amount:
1799800
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
1820647.68

Sources: Kentucky Secretary of State