BLUEGRASS INTERNAL MEDICINE, PLLC

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Company Details

Name:	BLUEGRASS INTERNAL MEDICINE, PLLC
Legal type:	Name Reservation
Status:	Inactive
File Date:	08 Mar 2004 (21 years ago)
Authority Date:	08 Mar 2004 (21 years ago)
Organization Number:	0580666

National Provider Identifier

NPI Number:

1619973682

Certification Date:

2021-03-24

Link:

View on NPI website

Authorized Person:

Name:

ANGELA LOUISE JARVIS

Role:

PRESIDENT

Phone:

2706851066

Taxonomy:

Selected Taxonomy:

363A00000X - Physician Assistant

Is Primary:

No

Selected Taxonomy:

363L00000X - Nurse Practitioner

Is Primary:

No

Selected Taxonomy:

207R00000X - Internal Medicine Physician

Is Primary:

Yes

Contacts:

Phone:

+1 270-685-1066

Fax:

2706850881

Form 5500 Series

Employer Identification Number (EIN):

611396631

Plan Year:

2024

Number Of Participants:

58

Sponsors Telephone Number:

2706851066

File:

Plan Year:

2023

Number Of Participants:

55

Sponsors Telephone Number:

2706851066

File:

Plan Year:

2023

Number Of Participants:

2

Sponsors Telephone Number:

8593734176

File:

Plan Year:

2022

Number Of Participants:

60

Sponsors Telephone Number:

2706851066

File:

Plan Year:

2021

Number Of Participants:

60

Sponsors Telephone Number:

2706851066

File:

Assumed Names

Name	Status	Expiration Date
BLUEGRASS INTERNAL MEDICINE, PLLC	Inactive	2004-07-06

USAspending Awards / Financial Assistance

Date:

2020-04-15

Link:

View on USAspending

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:

527485.00

Total Face Value Of Loan:

527485.00

Paycheck Protection Program

Jobs Reported:

49

Initial Approval Amount:

$490,587

Date Approved:

2021-03-12

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$490,587

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$492,699.25

Servicing Lender:

U.S. Bank, National Association

Use of Proceeds:

Payroll: $490,587

Jobs Reported:

49

Initial Approval Amount:

$527,485

Date Approved:

2020-04-15

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$527,485

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$533,096.85

Servicing Lender:

U.S. Bank, National Association

Use of Proceeds:

Payroll: $527,485

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Sources: Kentucky Secretary of State