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LEITCHFIELD PEDIATRIC CLINIC, P.S.C.

Company Details

Name: LEITCHFIELD PEDIATRIC CLINIC, P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 22 Jul 1996 (29 years ago)
Organization Date: 22 Jul 1996 (29 years ago)
Last Annual Report: 28 Jan 2025 (4 months ago)
Organization Number: 0419126
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 42754
City: Leitchfield
Primary County: Grayson County
Principal Office: 901 WALLACE AVE, LEITCHFIELD, KY 42754
Place of Formation: KENTUCKY
Authorized Shares: 100

Registered Agent

Name Role
ANTHONY SMITH Registered Agent

Incorporator

Name Role
JOSEPH M. LEE, M.D. Incorporator

President

Name Role
John E Evans President

Vice President

Name Role
Anthony K Smtih Vice President

Director

Name Role
John E Evans Director
Anthony K Smith Director
Elizabeth S Stivers Director

Shareholder

Name Role
John E Evans Shareholder
Anthony K Smith Shareholder
Elizabeth S Stivers Shareholder

U.S. Small Business Administration Profile

The U.S. Small Business Administration (SBA) helps Americans start, grow, and build resilient businesses.

Note: SBA was created in 1953 as an independent agency of the federal government to aid, counsel, assist and protect the interests of small business concerns; preserve free competitive enterprise; and maintain and strengthen the overall economy of our nation. SBA reviews Congressional and testifies on behalf of small businesses. It assesses the impact of regulatory burden on small businesses.

Phone Number:
Fax Number:
270-259-5309
Contact Person:
LYNN ROBINSON
Ownership and Self-Certifications:
Self-Certified Small Disadvantaged Business
User ID:
P2556430
Trade Name:
LEITCHFIELD PEDITRICS

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
XA9MHRCUD663
CAGE Code:
8SH28
UEI Expiration Date:
2025-09-27

Business Information

Doing Business As:
LEITCHFIELD PEDITRICS
Division Name:
LEITCHFIELD PEDIATRIC CLINIC PSC
Activation Date:
2024-10-01
Initial Registration Date:
2020-11-02

National Provider Identifier

NPI Number:
1558318543
Certification Date:
2020-10-20

Authorized Person:

Name:
LYNN ROBINSON
Role:
CREDITIALING
Phone:

Taxonomy:

Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
No
Selected Taxonomy:
363LP0200X - Pediatric Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
261QR1300X - Rural Health Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2702595309

Form 5500 Series

Employer Identification Number (EIN):
611306896
Plan Year:
2013
Number Of Participants:
25
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
23
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
21
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
18
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
22
Sponsors Telephone Number:

Filings

Name File Date
Annual Report 2025-01-28
Annual Report 2024-03-25
Annual Report 2023-03-20
Annual Report 2022-03-10
Annual Report 2021-04-13

Sources: Kentucky Secretary of State