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MOUNTAIN VIEW FAMILY PRACTICE, PLLC

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Company Details

Name: MOUNTAIN VIEW FAMILY PRACTICE, PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
File Date: 27 Sep 2005 (20 years ago)
Organization Date: 27 Sep 2005 (20 years ago)
Last Annual Report: 04 Jun 2021 (4 years ago)
Managed By: Managers
Organization Number: 0622476
ZIP code: 40741
City: London, Marydell, Sasser, Tuttle
Primary County: Laurel County
Principal Office: 272 LONDON MOUNTAIN VIEW DRIVE, LONDON, KY 40741
Place of Formation: KENTUCKY

Manager

Name Role
SAMUEL D KREIS MD Manager

Organizer

Name Role
SAMUEL KREIS, M.D. Organizer

Registered Agent

Name Role
SAMUEL KREIS, M.D. Registered Agent

National Provider Identifier

NPI Number:
1265621213

Authorized Person:

Name:
DR. SAMUEL DUANE KREIS I
Role:
CEO/DOCTOR
Phone:

Taxonomy:

Selected Taxonomy:
363AM0700X - Medical Physician Assistant
Is Primary:
No
Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
6068772857

Form 5500 Series

Employer Identification Number (EIN):
203586908
Plan Year:
2020
Number Of Participants:
16
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
15
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
14
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
14
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
15
Sponsors Telephone Number:

Filings

Name File Date
Administrative Dissolution 2022-10-04
Annual Report 2021-06-04
Annual Report 2020-08-13
Annual Report 2019-05-29
Annual Report 2018-08-16

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Sources: Kentucky Secretary of State