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Specialty Physician Assistant LLC

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Company Details

Name: Specialty Physician Assistant LLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 27 Aug 2013 (12 years ago)
Organization Date: 27 Aug 2013 (12 years ago)
Last Annual Report: 20 Apr 2025 (2 months ago)
Managed By: Members
Organization Number: 0865744
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 41501
City: Pikeville, Broad Bottom, Gulnare, Mccombs, Meta, Ne...
Primary County: Pike County
Principal Office: 158 Windward Lane, Pikeville, KY 41501
Place of Formation: KENTUCKY

Member

Name Role
James Hager DO Member
Nichol Burchfield Member
Richard Burchfield Member

Organizer

Name Role
Nichol Burchfield Organizer

Registered Agent

Name Role
Nichol Burchfield Registered Agent

National Provider Identifier

NPI Number:
1528484037
Certification Date:
2023-11-29

Authorized Person:

Name:
NICHOL BURCHFIELD
Role:
OWNER/MEMBER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
No
Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
6067540770

Assumed Names

Name Status Expiration Date
RUSSELL FORK WALK-IN CLINIC Expiring 2025-05-15
RUSSELL FORK WALKIN-IN CLINIC Inactive 2019-03-07

Filings

Name File Date
Annual Report 2025-04-20
Annual Report 2025-04-20
Annual Report 2024-06-27
Annual Report 2023-06-22
Annual Report 2023-06-21

USAspending Awards / Financial Assistance

Date:
2020-04-07
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:
10200.00
Total Face Value Of Loan:
10200.00

Paycheck Protection Program

Date Approved:
2020-04-04
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
10200
Current Approval Amount:
10200
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
10302.56

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Sources: Kentucky Secretary of State