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KENDALL E. HANSEN, M.D., PLC

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Company Details

Name: KENDALL E. HANSEN, M.D., PLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 03 Jan 2001 (25 years ago)
Organization Date: 03 Jan 2001 (25 years ago)
Last Annual Report: 16 May 2022 (3 years ago)
Managed By: Members
Organization Number: 0508196
ZIP code: 41017
City: Ft Mitchell, Bromley, Covington, Crescent Park, Cresc...
Primary County: Kenton County
Principal Office: 340 THOMAS MORE PARKWAY, SUITE 260, CRESTVIEW HILLS, KY 41017
Place of Formation: KENTUCKY

Organizer

Name Role
KENDALL E. HANSEN, M.D. Organizer

Member

Name Role
Kendall E Hansen MD Member
Charles A Roberts MD Member

Registered Agent

Name Role
KENDALL E. HANSEN, M.D. Registered Agent

Unique Entity ID

Unique Entity ID:
LYD8PJJ7P373
UEI Expiration Date:
2022-11-24

Business Information

Doing Business As:
INTERVENTIONAL PAIN SPECIALIST
Division Name:
KENDALL HANSEN
Activation Date:
2021-10-26
Initial Registration Date:
2021-08-23

National Provider Identifier

NPI Number:
1174528392
Certification Date:
2020-03-05

Authorized Person:

Name:
KENDALL E. HANSEN
Role:
M.D., PRESIDENT & CEO
Phone:

Taxonomy:

Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
208VP0014X - Interventional Pain Medicine Physician
Is Primary:
No
Selected Taxonomy:
207LP2900X - Pain Medicine (Anesthesiology) Physician
Is Primary:
Yes

Contacts:

Fax:
8599570703

Form 5500 Series

Employer Identification Number (EIN):
611383719
Plan Year:
2021
Number Of Participants:
60
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
61
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
61
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
60
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
58
Sponsors Telephone Number:

Assumed Names

Name Status Expiration Date
INTERVENTIONAL PAIN SPECIALISTS, PLC Inactive 2017-05-29

Filings

Name File Date
Administrative Dissolution 2023-10-04
Annual Report 2022-05-16
Annual Report 2021-05-24
Annual Report 2020-02-18
Annual Report 2019-05-07

USAspending Awards / Financial Assistance

Date:
2021-02-23
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:
745685.85
Total Face Value Of Loan:
745685.85

Paycheck Protection Program

Jobs Reported:
58
Initial Approval Amount:
$745,685.85
Date Approved:
2021-02-23
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$745,685.85
Race:
White
Ethnicity:
Unknown/NotStated
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$749,812.66
Servicing Lender:
Peoples Bank
Use of Proceeds:
Payroll: $745,683.85
Utilities: $1

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Sources: Kentucky Secretary of State