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JASPER MEDICAL GROUP, LLC - Florida Company Profile

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Company Details

Entity Name: JASPER MEDICAL GROUP, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Inactive
Date Filed: 30 Oct 2013 (12 years ago)
Date of dissolution: 07 Oct 2021 (4 years ago)
Last Event: LC VOLUNTARY DISSOLUTION
Event Date Filed: 07 Oct 2021 (4 years ago)
Document Number: L13000153072
FEI/EIN Number NOT APPLICABLE
Address: 4000 MERIDIAN BLVD, FRANKLIN, TN, 37067, US
Mail Address: 4000 MERIDIAN BLVD, FRANKLIN, TN, 37067, US
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Hammons Kevin J Manager 4000 MERIDIAN BLVD, FRANKLIN, TN, 37067
Hingtgen Tim L Manager 4000 MERIDIAN BLVD, FRANKLIN, TN, 37067
Fordham Benjamin C Manager 4000 MERIDIAN BLVD, FRANKLIN, TN, 37067
- Agent -

National Provider Identifier

NPI Number:
1932539475

Authorized Person:

Name:
MS. STACI LUCIUS
Role:
VICE PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G13000121018 HAMILTON PRIMARY CARE EXPIRED 2013-12-11 2018-12-31 - 1150 NW US41 NORTH, SUITE 11 AND 12, JASPER, FL, 32052

Events

Event Type Filed Date Value Description
LC VOLUNTARY DISSOLUTION 2021-10-07 - -
CHANGE OF PRINCIPAL ADDRESS 2014-05-01 4000 MERIDIAN BLVD, FRANKLIN, TN 37067 -
CHANGE OF MAILING ADDRESS 2014-05-01 4000 MERIDIAN BLVD, FRANKLIN, TN 37067 -
REGISTERED AGENT NAME CHANGED 2014-02-25 CORPORATION SERVICE COMPANY -
REGISTERED AGENT ADDRESS CHANGED 2014-02-25 1201 HAYS STREET, TALLAHASSEE, FL 32301 -

Documents

Name Date
LC Voluntary Dissolution 2021-10-07
ANNUAL REPORT 2021-04-23
ANNUAL REPORT 2020-05-03
ANNUAL REPORT 2019-04-26
ANNUAL REPORT 2018-04-25
ANNUAL REPORT 2017-04-18
ANNUAL REPORT 2016-04-28
ANNUAL REPORT 2015-04-21
ANNUAL REPORT 2014-05-01
Reg. Agent Change 2014-02-25

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Date of last update: 01 Jul 2025

Sources: Florida Department of State