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BLAINE PAYNE, INC. - Florida Company Profile

Company Details

Entity Name: BLAINE PAYNE, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

BLAINE PAYNE, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.

Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 20 May 2014 (11 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 19 Feb 2024 (a year ago)
Document Number: P14000045295
FEI/EIN Number 47-1029812

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 180 NW HAYNES STREET, MADISON, FL, 32340, US
Mail Address: P.O. BOX 185, MADISON, FL, 32341, US
ZIP code: 32340
County: Madison
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1770943409 2016-02-23 2016-06-30 PO BOX 185, MADISON, FL, 323410185, US 180 NW HAYNES ST, MADISON, FL, 323402010, US

Contacts

Phone +1 850-973-1215
Fax 8669234163

Authorized person

Name TAMMEY REVELS
Role BUSINESS MANAGER
Phone 8509731215

Taxonomy

Taxonomy Code 207QG0300X - Geriatric Medicine (Family Medicine) Physician
License Number OS9255
State FL
Is Primary Yes

Other Provider Identifiers

Issuer BCBS
Number 37137
Issuer MEDICAID
Number 272752800
State FL
Issuer HUMANA
Number HUMANA
Issuer BCBS
Number SXJQY

Key Officers & Management

Name Role Address
PAYNE THERESA B President Post Office Box 185, Madison, FL, 32341
PAYNE THERESA B Treasurer Post Office Box 185, Madison, FL, 32341
Ball Angela M Agent 615 N. JEFFERSON ST., PERRY, FL, 32347

Events

Event Type Filed Date Value Description
REINSTATEMENT 2024-02-19 - -
REGISTERED AGENT NAME CHANGED 2024-02-19 Ball, Angela M. -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2023-09-22 - -
CHANGE OF PRINCIPAL ADDRESS 2016-02-16 180 NW HAYNES STREET, MADISON, FL 32340 -
CHANGE OF MAILING ADDRESS 2016-02-16 180 NW HAYNES STREET, MADISON, FL 32340 -

Documents

Name Date
REINSTATEMENT 2024-02-19
ANNUAL REPORT 2022-03-24
ANNUAL REPORT 2021-04-19
ANNUAL REPORT 2020-03-19
ANNUAL REPORT 2019-04-26
ANNUAL REPORT 2018-04-30
ANNUAL REPORT 2017-04-26
ANNUAL REPORT 2016-04-28
ANNUAL REPORT 2015-04-28
Domestic Profit 2014-05-20

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
4154387407 2020-05-08 0491 PPP 180 NW HAYNES ST, MADISON, FL, 32340-2010
Loan Status Date 2021-03-06
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 22220
Loan Approval Amount (current) 22220
Undisbursed Amount 0
Franchise Name -
Lender Location ID 123975
Servicing Lender Name Madison County Community Bank
Servicing Lender Address 301 E Base St, MADISON, FL, 32340-2405
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address MADISON, MADISON, FL, 32340-2010
Project Congressional District FL-02
Number of Employees 4
NAICS code 621111
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 123975
Originating Lender Name Madison County Community Bank
Originating Lender Address MADISON, FL
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 22381.1
Forgiveness Paid Date 2021-02-01
2936889010 2021-05-18 0491 PPS 180 NW Haynes St, Madison, FL, 32340-2010
Loan Status Date 2022-01-06
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 30602.5
Loan Approval Amount (current) 30602.5
Undisbursed Amount 0
Franchise Name -
Lender Location ID 123975
Servicing Lender Name Madison County Community Bank
Servicing Lender Address 301 E Base St, MADISON, FL, 32340-2405
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address Madison, MADISON, FL, 32340-2010
Project Congressional District FL-02
Number of Employees 4
NAICS code 621111
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 123975
Originating Lender Name Madison County Community Bank
Originating Lender Address MADISON, FL
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 30760.61
Forgiveness Paid Date 2021-12-06

Date of last update: 02 Mar 2025

Sources: Florida Department of State