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VERSAILLES FAMILY MEDICINE, PLLC

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Company Details

Name: VERSAILLES FAMILY MEDICINE, PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 08 Sep 2006 (19 years ago)
Organization Date: 08 Sep 2006 (19 years ago)
Last Annual Report: 10 Mar 2025 (5 months ago)
Managed By: Members
Organization Number: 0646640
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 40383
City: Versailles
Primary County: Woodford County
Principal Office: 460 WILSON AVENUE, FIRST FLOOR, VERSAILLES, KY 40383
Place of Formation: KENTUCKY

Organizer

Name Role
BRIAN A. SMITH Organizer

Member

Name Role
Brian Aaron Smith Member

Registered Agent

Name Role
BRIAN A. SMITH Registered Agent

Unique Entity ID

Unique Entity ID:
PZVCN9JHJMF9
CAGE Code:
8MVT2
UEI Expiration Date:
2025-08-26

Business Information

Doing Business As:
VERSAILLES FAMILY MEDICINE
Activation Date:
2024-08-29
Initial Registration Date:
2020-04-13

Commercial and government entity program

CAGE number:
8MVT2
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2024-08-29
SAM Expiration:
2025-08-26

Contact Information

POC:
BRIAN SMITH
Corporate URL:
www.versaillesfamilymedicine.com

National Provider Identifier

NPI Number:
1548316763
Certification Date:
2022-05-19

Authorized Person:

Name:
BRIAN A SMITH
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
No
Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
363AM0700X - Medical Physician Assistant
Is Primary:
No
Selected Taxonomy:
363LA2200X - Adult Health Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
8598790363

Form 5500 Series

Employer Identification Number (EIN):
113800760
Plan Year:
2024
Number Of Participants:
32
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
31
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
33
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
27
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
24
Sponsors Telephone Number:

Assumed Names

Name Status Expiration Date
LAWRENCEBURG FAMILY MEDICINE Inactive 2024-04-26
MIDWAY FAMILY MEDICINE Inactive 2021-10-19

Filings

Name File Date
Annual Report 2025-03-10
Annual Report 2024-02-14
Annual Report 2023-02-07
Annual Report 2022-05-18
Annual Report 2021-02-03

USAspending Awards / Financial Assistance

Date:
2020-04-11
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:
302800.00
Total Face Value Of Loan:
302800.00
Date:
2013-07-15
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE
Obligated Amount:
0.00
Face Value Of Loan:
668000.00
Total Face Value Of Loan:
668000.00

Paycheck Protection Program

Jobs Reported:
20
Initial Approval Amount:
$302,800
Date Approved:
2020-04-10
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$302,800
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$305,396.61
Servicing Lender:
Community Trust Bank, Inc.
Use of Proceeds:
Payroll: $302,800

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Sources: Kentucky Secretary of State