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  5. DERMATOLOGY CENTER OF OWENSBORO, PLLC

DERMATOLOGY CENTER OF OWENSBORO, PLLC

Company Details

Name: DERMATOLOGY CENTER OF OWENSBORO, PLLC
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
File Date: 05 Feb 2015 (10 years ago)
Organization Date: 05 Feb 2015 (10 years ago)
Last Annual Report: 25 Mar 2024 (10 months ago)
Managed By: Members
Organization Number: 0909663
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 42303
Primary County: Daviess
Principal Office: 2200 EAST PARRISH AVENUE, BUILDING E, SUITE 205, OWENSBORO, KY 42303
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DERMATOLOGY CENTER OF OWENSBORO 401(K) PLAN 2023 473036845 2024-08-22 DERMATOLOGY CENTER OF OWENSBORO 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-04-01
Business code 621111
Sponsor’s telephone number 2706631078
Plan sponsor’s address 2200 EAST PARRISH AVE. BLDG. E, SUITE 205, OWENSBORO, KY, 42303
DERMATOLOGY CENTER OF OWENSBORO 401(K) PLAN 2022 473036845 2023-10-03 DERMATOLOGY CENTER OF OWENSBORO 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-04-01
Business code 621111
Sponsor’s telephone number 2706631078
Plan sponsor’s address 2200 EAST PARRISH AVE. BLDG. E, SUITE 205, OWENSBORO, KY, 42303
DERMATOLOGY CENTER OF OWENSBORO PLLC CBS BENEFIT PLAN 2022 473036845 2023-12-27 DERMATOLOGY CENTER OF OWENSBORO PLLC 4
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 621491
Sponsor’s telephone number 2706631078
Plan sponsor’s address 2200 EAST PARRISH AVE, UNIT E205, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2023-12-27
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
DERMATOLOGY CENTER OF OWENSBORO 401(K) PLAN 2021 473036845 2022-09-13 DERMATOLOGY CENTER OF OWENSBORO 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-04-01
Business code 621111
Sponsor’s telephone number 2706631078
Plan sponsor’s address 2200 EAST PARRISH AVE. BLDG. E, STE. 205, OWENSBORO, KY, 42303
DERMATOLOGY CENTER OF OWENSBORO PLLC CBS BENEFIT PLAN 2021 473036845 2022-12-29 DERMATOLOGY CENTER OF OWENSBORO PLLC 1
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 621491
Sponsor’s telephone number 2706631078
Plan sponsor’s address 2200 EAST PARRISH AVE, UNIT E205, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2022-12-29
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
DERMATOLOGY CENTER OF OWENSBORO PLLC CBS BENEFIT PLAN 2020 473036845 2021-12-14 DERMATOLOGY CENTER OF OWENSBORO PLLC 2
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 621491
Sponsor’s telephone number 2706631078
Plan sponsor’s address 2200 EAST PARRISH AVE, E205, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2021-12-14
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
DERMATOLOGY CENTER OF OWENSBORO 401(K) PLAN 2020 473036845 2021-09-28 DERMATOLOGY CENTER OF OWENSBORO 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-04-01
Business code 621111
Sponsor’s telephone number 2706631078
Plan sponsor’s address 2200 EAST PARRISH AVE. BLDG. E, STE. 205, OWENSBORO, KY, 42303

Signature of
Role Plan administrator
Date 2021-09-28
Name of individual signing BENJAMIN VESSELS
Valid signature Filed with authorized/valid electronic signature
DERMATOLOGY CENTER OF OWENSBORO PLLC CBS BENEFIT PLAN 2019 473036845 2020-12-23 DERMATOLOGY CENTER OF OWENSBORO PLLC 1
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 621491
Sponsor’s telephone number 2706631078
Plan sponsor’s address 2200 EAST PARRISH AVE, E205, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name KELLY WOLF
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2020-12-23
Name of individual signing KELLY WOLF
Valid signature Filed with authorized/valid electronic signature
DERMATOLOGY CENTER OF OWENSBORO 401(K) PLAN 2019 473036845 2020-07-15 DERMATOLOGY CENTER OF OWENSBORO 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-04-01
Business code 621111
Sponsor’s telephone number 2706631078
Plan sponsor’s address 2200 EAST PARRISH AVE., BLDG. E, STE. 205, OWENSBORO, KY, 42303

Signature of
Role Plan administrator
Date 2020-07-15
Name of individual signing BENJAMIN VESSELS
Valid signature Filed with authorized/valid electronic signature
DERMATOLOGY CENTER OF OWENSBORO 401(K) PLAN 2018 473036845 2019-09-17 DERMATOLOGY CENTER OF OWENSBORO 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-04-01
Business code 621111
Sponsor’s telephone number 2706631078
Plan sponsor’s address 2200 EAST PARRISH AVE., BLDG. E, STE. 205, OWENSBORO, KY, 42303

Signature of
Role Plan administrator
Date 2019-09-17
Name of individual signing BENJAMIN VESSELS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/10/02/20181002114554P040242311713001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2016-04-01
Business code 621111
Sponsor’s telephone number 2706631078
Plan sponsor’s address 2200 EAST PARRISH AVE., BLDG. E, SUITE 205, OWENSBORO, KY, 42303

Signature of
Role Plan administrator
Date 2018-10-02
Name of individual signing BENJAMIN VESSELS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/18/20170718104353P030053380657001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2016-04-01
Business code 621111
Sponsor’s telephone number 2706631078
Plan sponsor’s address 2200 EAST PARRISH AVE., BLDG. E, SUITE 205, OWENSBORO, KY, 42303

Signature of
Role Plan administrator
Date 2017-07-18
Name of individual signing BENJAMIN VESSELS
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
Mark W Starnes Registered Agent

Member

Name Role
Cassey Vessels Member

Organizer

Name Role
Mark W Starnes Organizer

Filings

Name File Date
Annual Report 2024-03-25
Registered Agent name/address change 2024-03-25
Annual Report 2023-05-08
Annual Report 2022-05-09
Annual Report 2021-04-19
Annual Report 2020-04-07
Annual Report 2019-06-05
Annual Report 2018-03-30
Annual Report 2017-04-10
Principal Office Address Change 2016-02-24

Related by officers

Mark W Starnes

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Related by address

No related companies by address

Date of last update: 17 Nov 2024

Sources: Kentucky Secretary of State

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