AMERICAN BOARD OF FAMILY MEDICINE, INC.

Company Details

Name:	AMERICAN BOARD OF FAMILY MEDICINE, INC.
Jurisdiction:	Kentucky
Profit or Non-Profit:	Non-profit
Legal type:	Foreign Corporation
Status:	Active
Standing:	Good
File Date:	19 Jul 1979 (45 years ago)
Organization Number:	0119459
Industry:	Miscellaneous Services
Number of Employees:	Large (100+)
Primary County:	Fayette
Place of Formation:	MISSOURI
Authority Date:	19 Jul 1979 (45 years ago)
Last Annual Report:	13 Jun 2024 (5 months ago)
Principal Office:	1648 MCGRATHIANA PARKWAY, FIFTH FLOOR, LEXINGTON, KY 40511
Principal Office ZIP code:	40511

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

AMERICAN BOARD OF FAMILY MEDICINE, INC. PENSION PLAN

2023

430921226

2024-10-10

AMERICAN BOARD OF FAMILY MEDICINE, INC.

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8592695626
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY, SUITE 550, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2024-10-10
Name of individual signing	TRISHA LAYOW
Valid signature	Filed with authorized/valid electronic signature

AMERICAN BOARD OF FAMILY MEDICINE, INC. PENSION PLAN

2022

430921226

2023-10-13

AMERICAN BOARD OF FAMILY MEDICINE, INC.

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8592695626
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY, SUITE 550, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2023-10-13
Name of individual signing	TRISHA LAYOW
Valid signature	Filed with authorized/valid electronic signature

AMERICAN BOARD OF FAMILY MEDICINE, INC. PENSION PLAN

2021

430921226

2022-10-05

AMERICAN BOARD OF FAMILY MEDICINE, INC.

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8592695626
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY, SUITE 550, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2022-10-05
Name of individual signing	TRISHA LAYOW
Valid signature	Filed with authorized/valid electronic signature

AMERICAN BOARD OF FAMILY MEDICINE, INC. SAVINGS & PROFIT SHARING PLAN

2020

430921226

2021-07-26

AMERICAN BOARD OF FAMILY MEDICINE, INC

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1999-12-01
Business code	621111
Sponsor’s telephone number	8593357513
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY, 5TH FLOOR, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2021-07-26
Name of individual signing	ROGER M BEAN
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2021-07-26
Name of individual signing	ROGER M BEAN
Valid signature	Filed with authorized/valid electronic signature

AMERICAN BOARD OF FAMILY MEDICINE, INC. PENSION PLAN

2020

430921226

2021-09-27

AMERICAN BOARD OF FAMILY MEDICINE, INC.

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8889955700
Plan sponsor’s address	SUITE 550, 1648 MCGRATHIANA PARKWAY, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2021-09-27
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

AMERICAN BOARD OF FAMILY MEDICINE, INC. SAVINGS & PROFIT SHARING PLAN

2019

430921226

2020-10-04

AMERICAN BOARD OF FAMILY MEDICINE, INC.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1999-12-01
Business code	621111
Sponsor’s telephone number	8592695626
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY 5TH FLOOR, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2020-10-04
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2020-10-04
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

AMERICAN BOARD OF FAMILY MEDICINE, INC. PENSION PLAN

2019

430921226

2020-09-20

AMERICAN BOARD OF FAMILY MEDICINE, INC.

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8889955700
Plan sponsor’s address	SUITE 550, 1648 MCGRATHIANA PARKWAY, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2020-09-20
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

AMERICAN BOARD OF FAMILY MEDICINE, INC. PENSION PLAN

2018

430921226

2019-10-15

AMERICAN BOARD OF FAMILY MEDICINE, INC.

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8889955700
Plan sponsor’s address	SUITE 550, 1648 MCGRATHIANA PARKWAY, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2019-10-15
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

AMERICAN BOARD OF FAMILY MEDICINE, INC. SAVINGS & PROFIT SHARING PLAN

2018

430921226

2019-09-08

AMERICAN BOARD OF FAMILY MEDICINE, INC.

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1999-12-01
Business code	621111
Sponsor’s telephone number	8592695626
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY 5TH FLOOR, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2019-09-08
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2019-09-08
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

AMERICAN BOARD OF FAMILY MEDICINE, INC. PENSION PLAN

2017

430921226

2018-07-17

AMERICAN BOARD OF FAMILY MEDICINE, INC.

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8889955700
Plan sponsor’s address	SUITE 550, 1648 MCGRATHIANA PARKWAY, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2018-07-17
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2018/06/08/20180608100850P030003900425001.pdf
Three-digit plan number (PN)	001
Effective date of plan	1999-12-01
Business code	621111
Sponsor’s telephone number	8592695626
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY 5TH FLOOR, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2018-06-08
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2018-06-08
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2017/10/13/20171013115429P040166226381001.pdf
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8889955700
Plan sponsor’s address	SUITE 550, 1648 MCGRATHIANA PARKWAY, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2017-10-13
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2017/07/03/20170703170958P040035263729001.pdf
Three-digit plan number (PN)	001
Effective date of plan	1999-12-01
Business code	621111
Sponsor’s telephone number	8592695626
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY 5TH FLOOR, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2017-07-03
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2017-07-03
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/21/20160721173758P030043637703001.pdf
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8889955700
Plan sponsor’s address	SUITE 550, 1648 MCGRATHIANA PARKWAY, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2016-07-21
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2016/06/21/20160621120424P030003693751001.pdf
Three-digit plan number (PN)	001
Effective date of plan	1999-12-01
Business code	621111
Sponsor’s telephone number	8592695626
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY 5TH FLOOR, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2016-06-21
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2016-06-21
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2015/10/14/20151014161710P030045224871001.pdf
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8889955700
Plan sponsor’s address	SUITE 550, 1648 MCGRATHIANA PARKWAY, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2015-10-14
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2015/07/08/20150708094813P030100427665001.pdf
Three-digit plan number (PN)	001
Effective date of plan	1999-12-01
Business code	621111
Sponsor’s telephone number	8592695626
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY 5TH FLOOR, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2015-07-08
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2015-07-08
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/08/20140708153257P040012252285001.pdf
Three-digit plan number (PN)	001
Effective date of plan	1999-12-01
Business code	621111
Sponsor’s telephone number	8592695626
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY 5TH FLOOR, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2014-07-08
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2014-07-08
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2014/07/05/20140705143926P040008658031001.pdf
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8889955700
Plan sponsor’s address	SUITE 550, 1648 MCGRATHIANA PARKWAY, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2014-07-05
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2013/06/26/20130626131908P040097417157001.pdf
Three-digit plan number (PN)	001
Effective date of plan	1999-12-01
Business code	621111
Sponsor’s telephone number	8592695626
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY 5TH FLOOR, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2013-06-26
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2013-06-26
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/07/20131007120331P030001998647001.pdf
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8889955700
Plan sponsor’s address	SUITE 550, 1648 MCGRATHIANA PARKWAY, LEXINGTON, KY, 40511

Signature of

Role	Plan administrator
Date	2013-10-07
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/06/20121006155339P030000486516001.pdf
Three-digit plan number (PN)	001
Effective date of plan	1999-12-01
Business code	621111
Sponsor’s telephone number	8592695626
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY 5TH FLOOR, LEXINGTON, KY, 40511

Plan administrator’s name and address

Administrator’s EIN	430921226
Plan administrator’s name	AMERICAN BOARD OF FAMILY MEDICINE, INC.
Plan administrator’s address	1648 MCGRATHIANA PARKWAY 5TH FLOOR, LEXINGTON, KY, 40511
Administrator’s telephone number	8592695626

Signature of

Role	Plan administrator
Date	2012-10-06
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2012-10-06
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/05/20120705154323P030004912598001.pdf
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8889955700
Plan sponsor’s address	SUITE 550, 1648 MCGRATHIANA PARKWAY, LEXINGTON, KY, 40511

Plan administrator’s name and address

Administrator’s EIN	430921226
Plan administrator’s name	AMERICAN BOARD OF FAMILY MEDICINE, INC.
Plan administrator’s address	SUITE 550, 1648 MCGRATHIANA PARKWAY, LEXINGTON, KY, 40511
Administrator’s telephone number	8889955700

Signature of

Role	Plan administrator
Date	2012-07-05
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/14/20111014174023P040153033489001.pdf
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8889955700
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY SUITE 550, LEXINGTON, KY, 40511

Plan administrator’s name and address

Administrator’s EIN	430921226
Plan administrator’s name	AMERICAN BOARD OF FAMILY MEDICINE, INC.
Plan administrator’s address	1648 MCGRATHIANA PARKWAY SUITE 550, LEXINGTON, KY, 40511
Administrator’s telephone number	8889955700

Signature of

Role	Plan administrator
Date	2011-10-14
Name of individual signing	JOHN CLEMENTS
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2011/08/22/20110822105455P040539554736001.pdf
Three-digit plan number (PN)	001
Effective date of plan	1999-12-01
Business code	621111
Sponsor’s telephone number	8592695626
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY 5TH FLOOR, LEXINGTON, KY, 40511

Plan administrator’s name and address

Administrator’s EIN	430921226
Plan administrator’s name	AMERICAN BOARD OF FAMILY MEDICINE, INC.
Plan administrator’s address	1648 MCGRATHIANA PARKWAY 5TH FLOOR, LEXINGTON, KY, 40511
Administrator’s telephone number	8592695626

Signature of

Role	Plan administrator
Date	2011-08-22
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2011-08-22
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/07/20101007170601P040005200850001.pdf
Three-digit plan number (PN)	002
Effective date of plan	1980-01-01
Business code	813000
Sponsor’s telephone number	8889955700
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY SUITE 550, LEXINGTON, KY, 40511

Plan administrator’s name and address

Administrator’s EIN	430921226
Plan administrator’s name	AMERICAN BOARD OF FAMILY MEDICINE, INC.
Plan administrator’s address	1648 MCGRATHIANA PARKWAY SUITE 550, LEXINGTON, KY, 40511
Administrator’s telephone number	8889955700

Signature of

Role	Plan administrator
Date	2010-10-07
Name of individual signing	JOHN CLEMENTS
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/17/20100717150708P030380623521001.pdf
Three-digit plan number (PN)	001
Effective date of plan	1999-12-01
Business code	621111
Sponsor’s telephone number	8592695626
Plan sponsor’s address	1648 MCGRATHIANA PARKWAY 5TH FLOOR, LEXINGTON, KY, 40511

Plan administrator’s name and address

Administrator’s EIN	430921226
Plan administrator’s name	AMERICAN BOARD OF FAMILY MEDICINE, INC.
Plan administrator’s address	1648 MCGRATHIANA PARKWAY 5TH FLOOR, LEXINGTON, KY, 40511
Administrator’s telephone number	8592695626

Signature of

Role	Plan administrator
Date	2010-07-17
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

Role	Employer/plan sponsor
Date	2010-07-17
Name of individual signing	ROGER M. BEAN
Valid signature	Filed with authorized/valid electronic signature

Registered Agent

Name	Role
WARREN P. NEWTON, M.D.	Registered Agent

Treasurer

Name	Role
MOTT BLAIR	Treasurer

Director

Name	Role
WARREN P NEWTON	Director
GERARDO MORENO	Director
TANYA LORD	Director
CHRISTINE HANCOCK	Director
ANNA KUO	Director
GRANT HOEKZEMA	Director
BRENESSA LINDEMAN	Director
BARBRA RABSON	Director
STEPHEN WILSON	Director
CHRISTINA KELLY	Director
JONATHAN ROBERTS	Director
Y. JACK CHOU	Director
TIFFANI MAYCOCK	Director
BENJAMIN LEWIS BARNETT,	Director
RALPH C. BENSON, M.D.	Director
ALLISON BURDICK, JR., M.	Director
DONAL L. DUNPHY, M.D.	Director
JOAN ANZIA	Director
ANDREA ANDERSON	Director
SABESAN KARUPPIAH	Director
ROBERT M. BLAKE, M.D.	Director
GEORGE MACONES	Director
CARLOS GONZALES	Director
MOTT BLAIR	Director

Incorporator

Name	Role
MAC F. CAHAL	Incorporator
IIUS W. DAVIS	Incorporator
GERALD W. GORMAN	Incorporator

Secretary

Name	Role
WARREN P NEWTON	Secretary

President

Name	Role
WARREN P NEWTON	President

Officer

Name	Role
ANDREA ANDERSON	Officer

Former Company Names

Name	Action
AMERICAN BOARD OF FAMILY PRACTICE, INC.	Old Name

Assumed Names

Name	Status	Expiration Date
AMERICAN BOARD OF FAMILY PRACTICE, INC.	Inactive	2014-11-10

Filings

Name	File Date
Annual Report	2024-06-13
Annual Report	2023-06-20
Annual Report	2022-05-26
Annual Report	2021-05-17
Annual Report	2020-06-22
Annual Report	2019-05-30
Registered Agent name/address change	2019-05-30
Annual Report	2018-05-16
Annual Report	2017-05-26
Annual Report	2016-05-18
Annual Report	2015-05-04
Annual Report	2014-05-29
Renewal of Assumed Name Return	2014-05-28
Annual Report	2013-05-09
Annual Report	2012-05-03
Annual Report	2011-05-03
Annual Report	2010-04-21
Name Renewal	2009-06-24
Principal Office Address Change	2009-06-18
Registered Agent name/address change	2009-06-18

Date of last update: 17 Nov 2024

Sources: Kentucky Secretary of State

AMERICAN BOARD OF FAMILY MEDICINE, INC.

Company Details

form 5500

Registered Agent

Treasurer

Director

Incorporator

Secretary

President

Officer

Former Company Names

Assumed Names

Filings

Related by officers

Related by address