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  5. ELIZABETHTOWN EMERGENCY PHYSICIANS, LLC

ELIZABETHTOWN EMERGENCY PHYSICIANS, LLC

Company Details

Name: ELIZABETHTOWN EMERGENCY PHYSICIANS, LLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 12 Dec 2001 (23 years ago)
Organization Date: 12 Dec 2001 (23 years ago)
Last Annual Report: 26 Mar 2025 (24 days ago)
Managed By: Members
Organization Number: 0526984
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 42701
City: Elizabethtown, E Town
Primary County: Hardin County
Principal Office: 913 N DIXIE AVE, ELIZABETHTOWN, KY 42701
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EEP RETIREMENT PLAN 2023 611401114 2024-06-24 ELIZABETHTOWN EMERGENCY PHYSICIANS, LLC 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Plan sponsor’s address P.O. BOX 910530, LEXINGTON, KY, 405910530
ELIZABETHTOWN EMERGENCY PHYSICIANS CBS BENEFIT PLAN 2023 611401114 2024-12-30 ELIZABETHTOWN EMERGENCY PHYSICIANS 20
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2023-01-01
Business code 621491
Sponsor’s telephone number 8777836257
Plan sponsor’s address PO BOX 910530, LEXINGTON, KY, 40591

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name JOSEPH HSU
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2024-12-30
Name of individual signing JOSEPH HSU
Valid signature Filed with authorized/valid electronic signature
ELIZABETHTOWN EMERGENCY PHYSICIANS CBS BENEFIT PLAN 2022 611401114 2023-12-27 ELIZABETHTOWN EMERGENCY PHYSICIANS 21
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2023-01-01
Business code 621491
Sponsor’s telephone number 8777836257
Plan sponsor’s address PO BOX 910530, LEXINGTON, KY, 40591

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2023-12-27
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
EEP RETIREMENT PLAN 2022 611401114 2023-07-20 ELIZABETHTOWN EMERGENCY PHYSICIANS, LLC 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Plan sponsor’s address P.O. BOX 910530, LEXINGTON, KY, 405910530
EEP RETIREMENT PLAN 2021 611401114 2022-07-28 ELIZABETHTOWN EMERGENCY PHYSICIANS, LLC 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Plan sponsor’s address P.O. BOX 910530, LEXINGTON, KY, 405910530
EEP RETIREMENT PLAN 2020 611401114 2021-07-30 ELIZABETHTOWN EMERGENCY PHYSICIANS, LLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Plan sponsor’s address P.O. BOX 910530, LEXINGTON, KY, 405910530
EEP RETIREMENT PLAN 2019 611401114 2020-07-17 ELIZABETHTOWN EMERGENCY PHYSICIANS, LLC 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Plan sponsor’s address P.O. BOX 910530, LEXINGTON, KY, 405910530
EEP RETIREMENT PLAN 2018 611401114 2019-06-10 ELIZABETHTOWN EMERGENCY PHYSICIANS, LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Plan sponsor’s address P.O. BOX 910530, LEXINGTON, KY, 405910530
EEP RETIREMENT PLAN 2017 611401114 2018-07-13 ELIZABETHTOWN EMERGENCY PHYSICIANS, LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Plan sponsor’s address P.O. BOX 910530, LEXINGTON, KY, 405910530
EEP RETIREMENT PLAN 2016 611401114 2017-08-29 ELIZABETHTOWN EMERGENCY PHYSICIANS, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Plan sponsor’s address P.O. BOX 910530, LEXINGTON, KY, 405910530
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/19/20160719124015P030040027655001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 8777836257
Plan sponsor’s address P.O. BOX 910530, LEXINGTON, KY, 40591

Signature of
Role Plan administrator
Date 2016-07-19
Name of individual signing PETER POPOVICH
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/10/13/20151013084126P030045066817001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Plan sponsor’s address PO BOX 910530, LEXINGTON, KY, 405910530
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/06/08/20140608122135P030376595235001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Plan sponsor’s address PO BOX 910530, LEXINGTON, KY, 405910530
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/14/20131014113939P040037111491004.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 5022438830
Plan sponsor’s address PO BOX 910530, LEXINGTON, KY, 405910530

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing ROSS T WALTON MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/09/17/20120917143538P040002674437005.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 5022438830
Plan sponsor’s address PO BOX 910530, LEXINGTON, KY, 405910530

Plan administrator’s name and address
Administrator’s EIN 611401114
Plan administrator’s name ELIZABETHTOWN EMERGENCY PHYSICIANS
Plan administrator’s address PO BOX 910530, LEXINGTON, KY, 405910530
Administrator’s telephone number 5022438830

Signature of
Role Plan administrator
Date 2012-09-17
Name of individual signing ROSS T WALTON MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/03/20111003145457P030141648913007.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 5022438830
Plan sponsor’s address PO BOX 910530, LEXINGTON, KY, 405910530

Plan administrator’s name and address
Administrator’s EIN 611401114
Plan administrator’s name ELIZABETHTOWN EMERGENCY PHYSICIANS
Plan administrator’s address PO BOX 910530, LEXINGTON, KY, 405910530
Administrator’s telephone number 5022438830

Signature of
Role Plan administrator
Date 2011-10-03
Name of individual signing ROSS T WALTON MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/02/20101002132201P030004465809007.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 5022438830
Plan sponsor’s address PO BOX 910530, LEXINGTON, KY, 405910530

Plan administrator’s name and address
Administrator’s EIN 611401114
Plan administrator’s name ELIZABETHTOWN EMERGENCY PHYSICIANS
Plan administrator’s address PO BOX 910530, LEXINGTON, KY, 405910530
Administrator’s telephone number 5022438830

Signature of
Role Plan administrator
Date 2010-10-02
Name of individual signing ROBERT GILBERT
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
FBT LLC LEXINGTON Registered Agent

Member

Name Role
Scott Dishaw, D.O. Member
Peter Popovich,D.O. Member
Todd Bell, D.O. Member
Lize-Mari Dorfling,M.D. Member
Vincent Syers, M.D Member
Joseph Stone, M.D. Member
Berchaun Nicholls, M.D. Member
Ronnie Pridemore, M.D. Member
Tyler Corey, M.D. Member
Matthew Allinder, M.D. Member

Organizer

Name Role
MARTIN D BONNEY JR Organizer
ROBERT D GILBERT Organizer
GARY HARRIS Organizer

Filings

Name File Date
Annual Report 2025-03-26
Annual Report 2024-02-28
Annual Report 2023-06-02
Annual Report 2022-03-12
Annual Report 2021-04-13
Annual Report 2020-05-20
Annual Report 2019-02-05
Annual Report 2018-04-18
Annual Report 2017-05-19
Annual Report 2016-08-03

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
9067897009 2020-04-09 0457 PPP 913 N DIXIE AVE, ELIZABETHTOWN, KY, 42701-2503
Loan Status Date 2021-06-17
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 567000
Loan Approval Amount (current) 567000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 27542
Servicing Lender Name Republic Bank & Trust Company
Servicing Lender Address 601 W Market St Republic Corporate Center, LOUISVILLE, KY, 40202
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address ELIZABETHTOWN, HARDIN, KY, 42701-2503
Project Congressional District KY-02
Number of Employees 22
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 27542
Originating Lender Name Republic Bank & Trust Company
Originating Lender Address LOUISVILLE, KY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 573268.5
Forgiveness Paid Date 2021-05-21

U.S. Small Business Administration Profile

Status User ID Name of Firm Trade Name UEI Address
Active P3284728 ELIZABETHTOWN EMERGENCY PHYSICIANS, LLC - KL8HBFGHDZK1 913 N DIXIE AVE, ELIZABETHTOWN, KY, 42701-2503
Capabilities Statement Link -
Phone Number 877-783-6257
Fax Number 859-514-5521
E-mail Address cwatkins@eepdoc.com
WWW Page -
E-Commerce Website -
Contact Person CYNTHIA WATKINS
County Code (3 digit) 093
Congressional District 02
Metropolitan Statistical Area -
CAGE Code 9XFD4
Year Established 2001
Accepts Government Credit Card No
Legal Structure LLC
Ownership and Self-Certifications -
Business Development Servicing Office KENTUCKY DISTRICT OFFICE (SBA office code 0457)
Capabilities Narrative (none given)
Special Equipment/Materials (none given)
Business Type Percentages (none given)
Keywords (none given)
Quality Assurance Standards (none given)
Electronic Data Interchange capable -

SBA Federal Certifications
HUBZone Certified No
Women Owned Certified No
Women Owned Pending No
Economically Disadvantaged Women Owned Certified No
Economically Disadvantaged Women Owned Pending No
Veteran-Owned Small Business Certified No
Veteran-Owned Small Business Joint Venture No
Service-Disabled Veteran-Owned Small Business Certified No
Service-Disabled Veteran-Owned Small Business Joint Venture No

Bonding Levels
Description Construction Bonding Level (per contract)
Level (none given)
Description Construction Bonding Level (aggregate)
Level (none given)
Description Service Bonding Level (per contract)
Level (none given)
Description Service Bonding Level (aggregate)
Level (none given)

NAICS Codes with Size Determinations by NAICS
Primary Yes
Code 622110
NAICS Code's Description General Medical and Surgical Hospitals
Buy Green Yes

Export Profile (Trade Mission Online)
Exporter Firm hasn't answered this question yet
Export Business Activities (none given)
Exporting to (none given)
Desired Export Business Relationships (none given)
Description of Export Objective(s) (none given)

Related by officers

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Related by address

No related companies by address

Sources: Kentucky Secretary of State

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