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WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC

Company Details

Name: WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Good
File Date: 05 Jul 2002 (23 years ago)
Organization Date: 05 Jul 2002 (23 years ago)
Last Annual Report: 04 Apr 2023 (2 years ago)
Managed By: Members
Organization Number: 0540141
ZIP code: 42240
City: Hopkinsville
Primary County: Christian County
Principal Office: P.O. BOX 551, HOPKINSVILLE, KY 42240
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 401(K) PLAN 2023 611392908 2024-01-26 WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2024-01-26
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-01-26
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 401(K) PLAN 2022 611392908 2023-03-09 WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2023-03-09
Name of individual signing PARESH SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-03-09
Name of individual signing PARESH SHETH
Valid signature Filed with authorized/valid electronic signature
WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 401(K) PLAN 2021 611392908 2022-03-30 WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2022-03-30
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-03-30
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 401(K) PLAN 2020 611392908 2021-05-01 WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2021-04-26
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-26
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 401(K) PLAN 2019 611392908 2020-04-01 WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2020-03-26
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-03-26
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 401(K) PLAN 2018 611392908 2019-03-13 WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2019-03-13
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-03-13
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 401(K) PLAN 2017 611392908 2018-04-17 WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2018-04-17
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-04-17
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 401(K) PLAN 2016 611392908 2017-03-14 WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2017-03-14
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-03-14
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 401(K) PLAN 2015 611392908 2016-03-28 WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2016-03-28
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-03-28
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 401(K) PLAN 2014 611392908 2015-04-07 WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2015-04-07
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-07
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/03/25/20140325112102P040309584945001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2014-03-25
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-03-25
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/02/26/20130226144758P030034863061001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Signature of
Role Plan administrator
Date 2013-02-26
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-02-26
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/03/20/20120320103128P030245595664001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Plan administrator’s name and address
Administrator’s EIN 611392908
Plan administrator’s name WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC
Plan administrator’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240
Administrator’s telephone number 2708855003

Signature of
Role Plan administrator
Date 2012-03-20
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-03-20
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/03/15/20110315103010P030120589200001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Plan administrator’s name and address
Administrator’s EIN 611392908
Plan administrator’s name WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC
Plan administrator’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240
Administrator’s telephone number 2708855003

Signature of
Role Plan administrator
Date 2011-03-15
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-03-15
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/09/09/20100909122335P070060901425001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2708855003
Plan sponsor’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240

Plan administrator’s name and address
Administrator’s EIN 611392908
Plan administrator’s name WEST KENTUCKY NEUROLOGICAL MEDICINE, PLLC
Plan administrator’s address 1721 CANTON STREET, HOPKINSVILLE, KY, 42240
Administrator’s telephone number 2708855003

Signature of
Role Plan administrator
Date 2010-09-09
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-09
Name of individual signing MONA SHETH
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
PARESH V SHETH Registered Agent

Member

Name Role
Paresh V Sheth Member

Organizer

Name Role
PARESH V SHETH Organizer

Filings

Name File Date
Dissolution 2023-10-16
Annual Report 2023-04-04
Annual Report 2022-08-09
Annual Report 2021-04-22
Annual Report 2020-04-17
Annual Report 2019-04-24
Annual Report 2018-03-30
Annual Report 2017-04-25
Annual Report 2016-04-05
Annual Report 2015-04-28

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3552908405 2021-02-05 0457 PPS 1721 Canton St, Hopkinsville, KY, 42240-1991
Loan Status Date 2021-09-16
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 74787
Loan Approval Amount (current) 74787
Undisbursed Amount 0
Franchise Name -
Lender Location ID 120955
Servicing Lender Name Planters Bank, Inc.
Servicing Lender Address 1312 S Main St, HOPKINSVILLE, KY, 42240-2016
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Hopkinsville, CHRISTIAN, KY, 42240-1991
Project Congressional District KY-01
Number of Employees 5
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 120955
Originating Lender Name Planters Bank, Inc.
Originating Lender Address HOPKINSVILLE, KY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 75208.72
Forgiveness Paid Date 2021-08-31
9432747009 2020-04-09 0457 PPP 1721 CANTON ST, HOPKINSVILLE, KY, 42240-1991
Loan Status Date 2021-01-14
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 74787
Loan Approval Amount (current) 74787
Undisbursed Amount 0
Franchise Name -
Lender Location ID 120955
Servicing Lender Name Planters Bank, Inc.
Servicing Lender Address 1312 S Main St, HOPKINSVILLE, KY, 42240-2016
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address HOPKINSVILLE, CHRISTIAN, KY, 42240-1991
Project Congressional District KY-01
Number of Employees 5
NAICS code 622110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 120955
Originating Lender Name Planters Bank, Inc.
Originating Lender Address HOPKINSVILLE, KY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 75295.97
Forgiveness Paid Date 2020-12-17

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Sources: Kentucky Secretary of State

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