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Fairview Physicians Network, LLC

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Company Details

Name: Fairview Physicians Network, LLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 11 Apr 2011 (14 years ago)
Organization Date: 11 Apr 2011 (14 years ago)
Last Annual Report: 18 Feb 2025 (4 months ago)
Managed By: Managers
Organization Number: 0789064
Industry: Health Services
Number of Employees: Large (100+)
ZIP code: 42240
City: Hopkinsville
Primary County: Christian County
Principal Office: 102 WEST 18TH STREET, HOPKINSVILLE, KY 42240
Place of Formation: KENTUCKY

Manager

Name Role
Jennie Stuart Medical Center Inc Manager

Organizer

Name Role
Lee T White Organizer

Registered Agent

Name Role
Lee T White Registered Agent

National Provider Identifier

NPI Number:
1659923316

Authorized Person:

Name:
AUTUMN BAILEY
Role:
MANAGED CARE DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
207RH0003X - Hematology & Oncology Physician
Is Primary:
No
Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207RX0202X - Medical Oncology Physician
Is Primary:
Yes

Contacts:

Fax:
2707072103

Form 5500 Series

Employer Identification Number (EIN):
452032126
Plan Year:
2016
Number Of Participants:
114
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
84
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
17
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
16
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
14
Sponsors Telephone Number:

Assumed Names

Name Status Expiration Date
JENNIE STUART MEDICAL GROUP Active 2025-11-20
KENTUCKY WOMEN'S HEALTH Expiring 2025-06-02
DIGESTIVE HEALTHCARE OF WESTERN KENTUCKY Inactive 2018-03-01
GUTHRIEMD Inactive 2017-03-30
BLUEGRASSMD Inactive 2016-06-10

Filings

Name File Date
Annual Report 2025-02-18
Annual Report 2024-03-06
Annual Report 2023-03-20
Annual Report 2022-03-08
Annual Report 2021-02-10

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Sources: Kentucky Secretary of State