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JACKSON PHYSICIAN CORP.

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Company Details

Name: JACKSON PHYSICIAN CORP.
Legal type: Kentucky Corporation
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 20 Mar 1996 (29 years ago)
Organization Date: 20 Mar 1996 (29 years ago)
Last Annual Report: 12 Jun 2024 (a year ago)
Organization Number: 0413596
Industry: Health Services
Number of Employees: Large (100+)
Principal Office: 1573 MALLORY LANE, SUITE 100, BRENTWOOD, TN 37027
Place of Formation: KENTUCKY
Authorized Shares: 1000

Secretary

Name Role
Donald R. Esposito, Jr. Secretary

Treasurer

Name Role
Alfred C. Lumsdaine Treasurer
Glenn A. Hargreaves Treasurer

Director

Name Role
Alfred Lumsdaine Director
Martin D. Smith Director

Registered Agent

Name Role
CT CORPORATION SYSTEM Registered Agent

President

Name Role
Scott Raplee President
Alfred Lumsdaine President

Incorporator

Name Role
ROBIN J. PAYTON Incorporator

Officer

Name Role
Stacey A. Donegan Officer

National Provider Identifier

NPI Number:
1063712701

Authorized Person:

Name:
DEBBIE BREWER
Role:
DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary:
Yes

Contacts:

Fax:
6066666118

Assumed Names

Name Status Expiration Date
JACKSON'S WOMEN'S CARE Active 2030-01-23
KENTUCKY RIVER PAIN MANAGEMENT Active 2030-01-23
HOMETOWN SURGICAL CENTER Inactive 2022-07-24
KENTUCKY RIVER HEART CENTER Inactive 2022-05-22
KENTUCKY RIVER E.N.T. Inactive 2022-05-16

Filings

Name File Date
Certificate of Assumed Name 2025-01-23
Certificate of Assumed Name 2025-01-23
Annual Report 2024-06-12
Annual Report 2023-04-11
Annual Report 2022-06-21

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Sources: Kentucky Secretary of State