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  5. BLUEGRASS MEDICAL CLINIC, PLLC

BLUEGRASS MEDICAL CLINIC, PLLC

Company Details

Name: BLUEGRASS MEDICAL CLINIC, PLLC
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Good
File Date: 21 Sep 2001 (23 years ago)
Organization Date: 21 Sep 2001 (23 years ago)
Last Annual Report: 14 Apr 2015 (10 years ago)
Managed By: Members
Organization Number: 0522836
ZIP code: 40361
Primary County: Bourbon
Principal Office: 1035 CYNTHIANA ROAD, PARIS, KY 40361
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLUEGRASS MEDICAL CLINIC PLLC 401(K) PROFIT SHARING PLAN 2015 610990080 2016-02-01 BLUEGRASS MEDICAL CLINIC, PLLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 8599870074
Plan sponsor’s address 22 CLINIC DRIVE, PARIS, KY, 40361

Signature of
Role Plan administrator
Date 2016-02-01
Name of individual signing RAY YOUNG JR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-02-01
Name of individual signing RAY YOUNG JR
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS MEDICAL CLINIC PLLC 401(K) PROFIT SHARING PLAN 2014 610990080 2015-09-01 BLUEGRASS MEDICAL CLINIC, PLLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 8599870074
Plan sponsor’s address 22 CLINIC DRIVE, PARIS, KY, 40361

Signature of
Role Plan administrator
Date 2015-09-01
Name of individual signing RAY YOUNG JR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-01
Name of individual signing RAY YOUNG JR
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS MEDICAL CLINIC PLLC 401(K) PROFIT SHARING PLAN 2013 610990080 2014-04-28 BLUEGRASS MEDICAL CLINIC, PLLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 8599870074
Plan sponsor’s address 22 CLINIC DRIVE, PARIS, KY, 40361

Signature of
Role Plan administrator
Date 2014-04-28
Name of individual signing RAY YOUNG JR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-04-28
Name of individual signing RAY YOUNG JR
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS MEDICAL CLINIC PLLC 401(K) PROFIT SHARING PLAN 2012 610990080 2013-05-21 BLUEGRASS MEDICAL CLINIC, PLLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 8599870074
Plan sponsor’s address 22 CLINIC DRIVE, PARIS, KY, 40361

Signature of
Role Plan administrator
Date 2013-05-21
Name of individual signing RAY YOUNG JR.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-21
Name of individual signing RAY YOUNG JR.
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS MEDICAL CLINIC, PLLC 401(K) PROFIT SHARING PLAN 2011 610990080 2012-04-23 BLUEGRASS MEDICAL CLINIC, PLLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 8599870074
Plan sponsor’s address 22 CLINIC DRIVE, PARIS, KY, 40361

Plan administrator’s name and address
Administrator’s EIN 610990080
Plan administrator’s name BLUEGRASS MEDICAL CLINIC, PLLC
Plan administrator’s address 22 CLINIC DRIVE, PARIS, KY, 40361
Administrator’s telephone number 8599870074

Signature of
Role Plan administrator
Date 2012-04-23
Name of individual signing RAY YOUNG JR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-04-23
Name of individual signing RAY YOUNG JR
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS MEDICAL CLINIC, PLLC 401(K) PROFIT SHARING PLAN 2010 610990080 2011-05-03 BLUEGRASS MEDICAL CLINIC, PLLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 8599870074
Plan sponsor’s address 22 CLINIC DRIVE, PARIS, KY, 40361

Plan administrator’s name and address
Administrator’s EIN 610990080
Plan administrator’s name BLUEGRASS MEDICAL CLINIC, PLLC
Plan administrator’s address 22 CLINIC DRIVE, PARIS, KY, 40361
Administrator’s telephone number 8599870074

Signature of
Role Plan administrator
Date 2011-05-03
Name of individual signing JEFFREY GREEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-05-03
Name of individual signing JEFFREY GREEN
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS MEDICAL CLINIC, PLLC 401(K) PROFIT SHARING PLAN 2009 610990080 2010-06-21 BLUEGRASS MEDICAL CLINIC, PLLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 8599870074
Plan sponsor’s address 22 CLINIC DRIVE, PARIS, KY, 40361

Plan administrator’s name and address
Administrator’s EIN 610990080
Plan administrator’s name BLUEGRASS MEDICAL CLINIC, PLLC
Plan administrator’s address 22 CLINIC DRIVE, PARIS, KY, 40361
Administrator’s telephone number 8599870074

Signature of
Role Plan administrator
Date 2010-06-21
Name of individual signing JEFFERY GREEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-06-21
Name of individual signing JEFFERY GREEN
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
NATHAN L. MOORE Registered Agent

Member

Name Role
C Ray Young Jr Member
Nathan L Moore Member

Signature

Name Role
NATHAN L MOORE Signature
C RAY YOUNG JR. Signature

Organizer

Name Role
WILLIAM H. ENGLE, SR. Organizer

Filings

Name File Date
Dissolution 2015-12-29
Annual Report 2015-04-14
Principal Office Address Change 2015-02-05
Registered Agent name/address change 2015-02-05
Annual Report 2014-03-27
Annual Report 2013-02-19
Annual Report 2012-01-31
Annual Report 2011-03-30
Annual Report 2010-03-18
Annual Report 2009-02-16

Related by officers

NATHAN L. MOORE

RPN, INC. E H CONWAY, LLC E.H. CONWAY, LLC

NATHAN L MOORE

RPN, INC.

WILLIAM H. ENGLE, SR.

MIDWEST MANAGEMENT SERVICES, INC. PARTNERS IN PRACTICE, LLC

Related by address

1035 CYNTHIANA ROAD, PARIS, KY 40361

RPN, INC.

Date of last update: 28 Dec 2024

Sources: Kentucky Secretary of State

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