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  5. Bluegrass Vision Group, PLLC

Bluegrass Vision Group, PLLC

Company Details

Name: Bluegrass Vision Group, PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 31 Aug 2016 (9 years ago)
Organization Date: 31 Aug 2016 (9 years ago)
Last Annual Report: 23 Feb 2025 (2 months ago)
Managed By: Members
Organization Number: 0961697
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 40353
City: Mount Sterling, Camargo, Mt Sterling
Primary County: Montgomery County
Principal Office: 25 Sterling Way, Mount Sterling, KY 40353
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLUEGRASS VISION GROUP CBS BENEFIT PLAN 2023 813724927 2024-12-30 BLUEGRASS VISION GROUP 6
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 621320
Sponsor’s telephone number 8594984800
Plan sponsor’s address 25 STERLING WAY, MOUNT STERLIN, KY, 40353

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

Signature of
Role Plan administrator
Date 2024-12-30
Name of individual signing JOSEPH HSU
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS VISION GROUP 401K PLAN 2023 813724927 2024-09-25 BLUEGRASS VISION GROUP, PLLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2022-01-01
Business code 621320
Sponsor’s telephone number 6064224960
Plan sponsor’s address 25 STERLING WAY, STE C, MT STERLING, KY, 40353
BLUEGRASS VISION GROUP 401K PLAN 2022 813724927 2023-10-13 BLUEGRASS VISION GROUP, PLLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2022-01-01
Business code 621320
Sponsor’s telephone number 6064224960
Plan sponsor’s address 25 STERLING WAY, STE C, MT STERLING, KY, 40353
BLUEGRASS VISION GROUP CBS BENEFIT PLAN 2022 813724927 2023-12-27 BLUEGRASS VISION GROUP 8
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 621320
Sponsor’s telephone number 8594984800
Plan sponsor’s address 25 STERLING WAY, MOUNT STERLIN, KY, 40353

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
BLUEGRASS VISION GROUP CBS BENEFIT PLAN 2021 813724927 2022-12-29 BLUEGRASS VISION GROUP 7
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 621320
Sponsor’s telephone number 8594984800
Plan sponsor’s address 25 STERLING WAY, MOUNT STERLIN, KY, 40353

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
BLUEGRASS VISION GROUP CBS BENEFIT PLAN 2020 813724927 2021-12-14 BLUEGRASS VISION GROUP 6
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 621320
Sponsor’s telephone number 8594984800
Plan sponsor’s address 25 STERLING WAY, MOUNT STERLIN, KY, 40353

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
BLUEGRASS VISION GROUP CBS BENEFIT PLAN 2019 813724927 2020-12-23 BLUEGRASS VISION GROUP 4
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 621320
Sponsor’s telephone number 8594984800
Plan sponsor’s address 25 STERLING WAY, MOUNT STERLIN, KY, 40353

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

Organizer

Name Role
Justin Coleman Organizer

Member

Name Role
Justin E Coleman Member

Registered Agent

Name Role
Justin Coleman Registered Agent

Filings

Name File Date
Annual Report 2025-02-23
Annual Report 2024-06-04
Annual Report 2023-04-05
Annual Report 2022-03-11
Annual Report 2021-04-15
Annual Report 2020-06-02
Annual Report 2019-03-25
Annual Report 2018-07-21
Annual Report 2017-04-18

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3884658409 2021-02-05 0457 PPS 25 Sterling Way, Mount Sterling, KY, 40353-1174
Loan Status Date 2021-07-07
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 91267.5
Loan Approval Amount (current) 91267.5
Undisbursed Amount 0
Franchise Name -
Lender Location ID 74995
Servicing Lender Name City National Bank of West Virginia
Servicing Lender Address 3601 MacCorkle Ave SE, Charleston, WV, 25304
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address Mount Sterling, MONTGOMERY, KY, 40353-1174
Project Congressional District KY-06
Number of Employees 8
NAICS code 621320
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 120831
Originating Lender Name City National Bank of West Virginia
Originating Lender Address Versailles, KY
Gender Male Owned
Veteran Unanswered
Forgiveness Amount 91576.8
Forgiveness Paid Date 2021-06-15
1244647304 2020-04-28 0457 PPP 25 STERLING WAY, MOUNT STERLING, KY, 40353-1174
Loan Status Date 2021-03-11
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 89200
Loan Approval Amount (current) 89200
Undisbursed Amount 0
Franchise Name -
Lender Location ID 26796
Servicing Lender Name Peoples Exchange Bank
Servicing Lender Address 101 N Main St, WINCHESTER, KY, 40391-2607
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address MOUNT STERLING, MONTGOMERY, KY, 40353-1174
Project Congressional District KY-06
Number of Employees 9
NAICS code 621320
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 26796
Originating Lender Name Peoples Exchange Bank
Originating Lender Address WINCHESTER, KY
Gender Male Owned
Veteran Unanswered
Forgiveness Amount 89896.26
Forgiveness Paid Date 2021-02-16

Government Spending

Branch Date of Service Fiscal Year Cabinet Department Classification Item Name Amount
Executive 2024-08-12 2025 Education and Labor Cabinet Department For Workforce Investment Fin Assist/Non-State Emp Rehab-Client Serv Cst-1099 Rpt 515

Related by officers

Justin Coleman

DR. JUSTIN COLEMAN, OD, PLLC Bluegrass Vision Therapy PLLC Bluegrass Vision Group of Morehead PLLC Bluegrass Vision Group of Hamburg, PLLC

Related by address

No related companies by address

Sources: Kentucky Secretary of State

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