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  5. Mayfield Medical Group, LLC

Mayfield Medical Group, LLC

Company Details

Name: Mayfield Medical Group, LLC
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
File Date: 28 Mar 2013 (12 years ago)
Organization Date: 28 Mar 2013 (12 years ago)
Last Annual Report: 11 Jun 2024 (7 months ago)
Managed By: Managers
Organization Number: 0853810
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 42066
Primary County: Graves
Principal Office: 1019 PADUCAH RD SUITE B, MAYFIELD, KY 42066
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MAYFIELD MEDICAL GROUP, LLC 401(K) PLAN 2023 462400054 2024-06-17 MAYFIELD MEDICAL GROUP, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2708047408
Plan sponsor’s address 1019 PADUCAH ROAD, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2024-06-17
Name of individual signing MRS. ANGELA ZETTER
Valid signature Filed with authorized/valid electronic signature
MAYFIELD MEDICAL GROUP, LLC 401(K) PLAN 2022 462400054 2023-05-24 MAYFIELD MEDICAL GROUP, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2708047408
Plan sponsor’s address 1019 PADUCAH ROAD, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2023-05-24
Name of individual signing MRS. ANGELA ZETTER
Valid signature Filed with authorized/valid electronic signature
MAYFIELD MEDICAL GROUP, LLC 401(K) PLAN 2021 462400054 2022-10-10 MAYFIELD MEDICAL GROUP, LLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2708047408
Plan sponsor’s address 1019 PADUCAH ROAD, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2022-10-10
Name of individual signing MRS. ANGELA ZETTER
Valid signature Filed with authorized/valid electronic signature
MAYFIELD MEDICAL GROUP, LLC 401(K) PLAN 2020 462400054 2021-09-23 MAYFIELD MEDICAL GROUP, LLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2708047408
Plan sponsor’s address 1019 PADUCAH ROAD, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2021-09-23
Name of individual signing MRS. ANGELA ZETTER
Valid signature Filed with authorized/valid electronic signature
MAYFIELD MEDICAL GROUP, LLC 401(K) PLAN 2019 462400054 2020-07-08 MAYFIELD MEDICAL GROUP, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2702514562
Plan sponsor’s address 1029 MEDICAL CENTER CIRCLE, SUITE 200, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2020-07-08
Name of individual signing DALE JONES
Valid signature Filed with authorized/valid electronic signature
MAYFIELD MEDICAL GROUP, LLC 401(K) PLAN 2018 462400054 2019-10-15 MAYFIELD MEDICAL GROUP, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2702514562
Plan sponsor’s address 1029 MEDICAL CENTER CIRCLE, SUITE 200, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2019-10-15
Name of individual signing DALE JONES
Valid signature Filed with authorized/valid electronic signature
MAYFIELD MEDICAL GROUP, LLC 401(K) PLAN 2017 462400054 2018-06-05 MAYFIELD MEDICAL GROUP, LLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2702514562
Plan sponsor’s address 1029 MEDICAL CENTER CIRCLE, SUITE 200, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2018-06-05
Name of individual signing DR. DALE JONES MD
Valid signature Filed with authorized/valid electronic signature
MAYFIELD MEDICAL GROUP, LLC 401(K) PLAN 2016 462400054 2017-06-07 MAYFIELD MEDICAL GROUP, LLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2702514562
Plan sponsor’s address 1029 MEDICAL CENTER CIRCLE, SUITE 200, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2017-06-07
Name of individual signing DR. DALE JONES MD
Valid signature Filed with authorized/valid electronic signature
MAYFIELD MEDICAL GROUP, LLC 401(K) PLAN 2015 462400054 2016-04-21 MAYFIELD MEDICAL GROUP, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2702514562
Plan sponsor’s address 1029 MEDICAL CENTER CIRCLE, SUITE 200, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2016-04-21
Name of individual signing DR. DALE JONES MD
Valid signature Filed with authorized/valid electronic signature
MAYFIELD MEDICAL GROUP, LLC 401(K) PLAN 2014 462400054 2015-06-09 MAYFIELD MEDICAL GROUP, LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2702514562
Plan sponsor’s address 1029 MEDICAL CENTER CIRCLE, SUITE 200, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2015-06-09
Name of individual signing DR. DALE JONES MD
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
JULIE WHITLOCK Registered Agent

Member

Name Role
DAVID ZETTER Member
DARREN STONE Member

Manager

Name Role
Angela Zetter Manager

Organizer

Name Role
Shackelford Law Office, PLLC Organizer

Filings

Name File Date
Annual Report 2024-06-11
Annual Report 2023-06-07
Annual Report 2022-06-20
Registered Agent name/address change 2021-06-21
Principal Office Address Change 2021-06-21
Annual Report 2021-06-21
Annual Report 2020-06-18
Annual Report 2019-06-17
Annual Report 2018-06-19
Annual Report 2017-06-29

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DAVID ZETTER

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Angela Zetter

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Shackelford Law Office, PLLC

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Related by address

1019 PADUCAH RD SUITE B, MAYFIELD, KY 42066

STONE FAMILY PRACTICE, PLLC

Date of last update: 14 Nov 2024

Sources: Kentucky Secretary of State

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