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TRI-STATE GASTROENTEROLOGY ASSOCIATES, P.S.C.

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Company Details

Name: TRI-STATE GASTROENTEROLOGY ASSOCIATES, P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 14 Jan 1991 (35 years ago)
Organization Date: 14 Jan 1991 (35 years ago)
Last Annual Report: 25 Jun 2024 (a year ago)
Organization Number: 0281619
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 41017
City: Ft Mitchell, Bromley, Covington, Crescent Park, Cresc...
Primary County: Kenton County
Principal Office: 425 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017
Place of Formation: KENTUCKY
Authorized Shares: 1000

Shareholder

Name Role
SCOTT LEVERAGE Shareholder
JOEL WARREN Shareholder
SAMIR VERMNI Shareholder
ALLAN LAM Shareholder
MICHAEL JONES Shareholder
KARLINA PATTON Shareholder
DANIEL FAGEL Shareholder
CHADWICK HATFIELD Shareholder

Director

Name Role
STEPHEN W. HILTZ, M.D. Director
ROSS MCHENRY, M.D. Director
MICHAEL JONES Director
KARLINA PATTON Director
CHADWICK HATFIELD Director
DANIEL FAGEL Director
SCOTT LEVERAGE Director
JOEL WARREN Director
SAMIR VERMANI Director
ALLAN LAM Director

President

Name Role
SCOTT LEVERAGE President

Secretary

Name Role
CHADWICK HATFIELD Secretary

Treasurer

Name Role
KARLINA PATTON Treasurer

Vice President

Name Role
MICHAEL JONES Vice President

Incorporator

Name Role
STEPHEN W. HILTZ, M.D. Incorporator
ROSS MCHENRY, M.D. Incorporator

Registered Agent

Name Role
ROSS MCHENRY, MD Registered Agent

National Provider Identifier

NPI Number:
1306843842

Authorized Person:

Name:
DR. DANIEL G FAGEL
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207RG0100X - Gastroenterology Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
8593415701

Form 5500 Series

Employer Identification Number (EIN):
611192347
Plan Year:
2019
Number Of Participants:
98
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
120
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
113
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
105
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
117
Sponsors Telephone Number:

Former Company Names

Name Action
TRI-STATE DIGESTIVE DISORDERS CENTER, INC. Merger

Filings

Name File Date
Annual Report 2024-06-25
Annual Report 2023-05-01
Annual Report 2022-06-30
Annual Report 2021-06-16
Annual Report 2020-06-01

Paycheck Protection Program

Jobs Reported:
124
Initial Approval Amount:
$1,097,100
Date Approved:
2021-01-21
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$1,097,100
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$1,112,218.94
Servicing Lender:
Stock Yards Bank & Trust Company
Use of Proceeds:
Payroll: $1,097,097
Utilities: $1

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Sources: Kentucky Secretary of State