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Lake Cumberland Pediatrics, PLLC

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Company Details

Name: Lake Cumberland Pediatrics, PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 31 Jan 2017 (8 years ago)
Organization Date: 31 Jan 2017 (8 years ago)
Last Annual Report: 20 May 2024 (a year ago)
Managed By: Members
Organization Number: 0975014
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 42633
City: Monticello, Barrier, Bethesda, Betsey, Coopersville,...
Primary County: Wayne County
Principal Office: Po Box 1737, Monticello, KY 42633
Place of Formation: KENTUCKY

Member

Name Role
Joseph Clay Brown Member

Organizer

Name Role
Michael C Slone Organizer

Registered Agent

Name Role
Michael C Slone Registered Agent

National Provider Identifier

NPI Number:
1518406859
Certification Date:
2022-05-11

Authorized Person:

Name:
JOSEPH CLAY BROWN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
No
Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
261QR1300X - Rural Health Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
6067530291

Form 5500 Series

Employer Identification Number (EIN):
815179411
Plan Year:
2023
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
11
Sponsors Telephone Number:

Assumed Names

Name Status Expiration Date
LAKE CUMBERLAND PRIMARY CARE Active 2027-01-13
THE WALK-IN CLINIC Active 2027-01-12
LAKE CUMBERLAND PEDIATRICS AND MEDICINE Inactive 2022-02-09
LAKE CUMBERLAND PEDIATRICS AND INTERNAL MEDICINE Inactive 2022-02-09

Filings

Name File Date
Annual Report 2024-05-20
Annual Report 2023-03-15
Annual Report 2022-07-20
Certificate of Assumed Name 2022-01-13
Certificate of Assumed Name 2022-01-12

USAspending Awards / Financial Assistance

Date:
2020-04-09
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:
90835.00
Total Face Value Of Loan:
90835.00

Paycheck Protection Program

Date Approved:
2020-04-09
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
90835
Current Approval Amount:
90835
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
91362.35

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Sources: Kentucky Secretary of State