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  5. SANJIV GUPTA, M.D., P.S.C.

SANJIV GUPTA, M.D., P.S.C.

Company Details

Name: SANJIV GUPTA, M.D., P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 23 Aug 1999 (26 years ago)
Organization Date: 23 Aug 1999 (26 years ago)
Last Annual Report: 13 Jun 2024 (10 months ago)
Organization Number: 0479138
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 41143
City: Grayson, Fultz, Johns Run
Primary County: Carter County
Principal Office: 300 STATE HWY. 1947, GRAYSON, KY 41143
Place of Formation: KENTUCKY
Authorized Shares: 100

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SANJIV GUPTA, M.D., P.S.C. CASH BALANCE PLAN 2023 611351718 2025-01-17 SANJIV GUPTA, M.D., P.S.C. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 34, GRAYSON, KY, 41143
SANJIV GUPTA, M.D., P.S.C. 401(K) PROFIT SHARING PLAN 2023 611351718 2024-10-17 SANJIV GUPTA, M.D., P.S.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 47, GRAYSON, KY, 41143
SANJIV GUPTA, M.D., P.S.C. 401(K) PROFIT SHARING PLAN 2022 611351718 2023-10-12 SANJIV GUPTA, M.D., P.S.C. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 1947, GRAYSON, KY, 41143
SANJIV GUPTA, M.D., P.S.C. CASH BALANCE PLAN 2022 611351718 2025-01-17 SANJIV GUPTA, M.D., P.S.C. 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 34, GRAYSON, KY, 41143
SANJIV GUPTA, M.D., P.S.C. CASH BALANCE PLAN 2021 611351718 2022-10-16 SANJIV GUPTA, M.D., P.S.C. 15
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 1947, GRAYSON, KY, 41143
SANJIV GUPTA, M.D., P.S.C. 401(K) PROFIT SHARING PLAN 2021 611351718 2022-10-12 SANJIV GUPTA, M.D., P.S.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 1947, GRAYSON, KY, 41143
SANJIV GUPTA, M.D., P.S.C. 401(K) PROFIT SHARING PLAN 2020 611351718 2021-10-15 SANJIV GUPTA, M.D., P.S.C. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 1947, GRAYSON, KY, 41143
SANJIV GUPTA, M.D., P.S.C. CASH BALANCE PLAN 2020 611351718 2021-10-15 SANJIV GUPTA, M.D., P.S.C. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 1947, GRAYSON, KY, 41143
SANJIV GUPTA, M.D., P.S.C. CASH BALANCE PLAN 2019 611351718 2020-10-13 SANJIV GUPTA, M.D., P.S.C. 12
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 1947, GRAYSON, KY, 41143
SANJIV GUPTA, M.D., P.S.C. 401(K) PROFIT SHARING PLAN 2019 611351718 2020-10-12 SANJIV GUPTA, M.D., P.S.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 1947, GRAYSON, KY, 41143
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/10/16/20191016092623P030086096375001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 1947, GRAYSON, KY, 41143
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 1947, GRAYSON, KY, 41143
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/10/14/20191014145847P030075133729001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 1947, GRAYSON, KY, 41143
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/09/24/20180924103249P040207787079001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 1947, GRAYSON, KY, 41143
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/09/24/20180924100748P030146189229001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 1947, GRAYSON, KY, 41143
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/10/13/20171013133256P040223992145001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 47, GRAYSON, KY, 41143
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/10/13/20171013134150P030214170129001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 47, GRAYSON, KY, 41143
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/16/20161016190018P030029926279001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 47, GRAYSON, KY, 41143
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/16/20161016185619P030029924343001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 47, GRAYSON, KY, 41143
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/10/15/20151015120207P040050996321001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 47, GRAYSON, KY, 41143

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing RAJNI GUPTA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/10/14/20151014191318P040044875575001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 STATE HIGHWAY 47, GRAYSON, KY, 41143

Signature of
Role Plan administrator
Date 2015-10-14
Name of individual signing RAJNI GUPTA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/02/20141002140120P030011482269001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 ST. HWY 1947, GRAYSON, KY, 41143

Signature of
Role Plan administrator
Date 2014-10-02
Name of individual signing RAJNI GUPTA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-02
Name of individual signing SANJIV GUPTA, M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/05/06/20130506125218P030070832885001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 ST. HWY 1947, GRAYSON, KY, 41143

Signature of
Role Plan administrator
Date 2013-05-06
Name of individual signing RAJNI GUPTA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-06
Name of individual signing SANJIV GUPTA, M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/03/20121003095946P040000305542001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 ST. HWY 1947, GRAYSON, KY, 41143

Plan administrator’s name and address
Administrator’s EIN 611351718
Plan administrator’s name SANJIV GUPTA, M.D., P.S.C.
Plan administrator’s address 300 ST. HWY 1947, GRAYSON, KY, 41143
Administrator’s telephone number 6064742200

Signature of
Role Plan administrator
Date 2012-10-03
Name of individual signing RAJNI GUPTA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-03
Name of individual signing SANJIV GUPTA, M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/25/20110725095850P040464932768001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 ST. HWY 1947, GRAYSON, KY, 41143

Plan administrator’s name and address
Administrator’s EIN 611351718
Plan administrator’s name SANJIV GUPTA, M.D., P.S.C.
Plan administrator’s address 300 ST. HWY 1947, GRAYSON, KY, 41143
Administrator’s telephone number 6064742200

Signature of
Role Plan administrator
Date 2011-07-25
Name of individual signing RAJNI GUPTA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-25
Name of individual signing SANJIV GUPTA, M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/19/20100719121718P030041329187001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-03-13
Business code 621111
Sponsor’s telephone number 6064742200
Plan sponsor’s address 300 ST. HWY 1947, GRAYSON, KY, 41143

Plan administrator’s name and address
Administrator’s EIN 611351718
Plan administrator’s name SANJIV GUPTA, M.D., P.S.C.
Plan administrator’s address 300 ST. HWY 1947, GRAYSON, KY, 41143
Administrator’s telephone number 6064742200

Signature of
Role Plan administrator
Date 2010-07-19
Name of individual signing RAJNI GUPTA
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
SANJIV GUPTA Registered Agent

Incorporator

Name Role
SANJIV GUPTA Incorporator
RAJNI GUPTA Incorporator

President

Name Role
SANJIV GUPTA President

Shareholder

Name Role
SANJIV GUPTA Shareholder

Filings

Name File Date
Annual Report 2024-06-13
Annual Report 2023-06-30
Annual Report 2022-05-09
Annual Report 2021-04-14
Annual Report 2020-05-28
Annual Report 2019-06-24
Annual Report 2018-05-31
Annual Report 2017-05-09
Annual Report 2016-06-27
Annual Report 2015-05-18

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
8420858404 2021-02-13 0457 PPS 300 State Highway 1947, Grayson, KY, 41143-9325
Loan Status Date 2021-10-02
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 103000
Loan Approval Amount (current) 103000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 27041
Servicing Lender Name The First National Bank of Grayson
Servicing Lender Address 200 S Carol Malone Blvd, GRAYSON, KY, 41143-1368
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address Grayson, CARTER, KY, 41143-9325
Project Congressional District KY-04
Number of Employees 14
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 27041
Originating Lender Name The First National Bank of Grayson
Originating Lender Address GRAYSON, KY
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 103494.97
Forgiveness Paid Date 2021-08-18
7778107003 2020-04-08 0457 PPP 300 ST HWY 1947, GRAYSON, KY, 41143
Loan Status Date 2021-07-09
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 99300
Loan Approval Amount (current) 99300
Undisbursed Amount 0
Franchise Name -
Lender Location ID 27041
Servicing Lender Name The First National Bank of Grayson
Servicing Lender Address 200 S Carol Malone Blvd, GRAYSON, KY, 41143-1368
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address GRAYSON, CARTER, KY, 41143-0001
Project Congressional District KY-05
Number of Employees 14
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 27041
Originating Lender Name The First National Bank of Grayson
Originating Lender Address GRAYSON, KY
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 100444.71
Forgiveness Paid Date 2021-06-10

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SANJIV GUPTA

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RAJNI GUPTA

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Sources: Kentucky Secretary of State

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