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BUFFALO TRACE GASTROENTEROLOGY PLLC

Company Details

Name: BUFFALO TRACE GASTROENTEROLOGY PLLC
Jurisdiction: Kentucky
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
File Date: 24 Jul 2006 (18 years ago)
Organization Date: 24 Jul 2006 (18 years ago)
Organization Number: 0643385
Primary County: Mason
Place of Formation: KENTUCKY
Last Annual Report: 10 Feb 2021 (4 years ago)
Managed By: Members
Principal Office: MEADOWVIEW PHYSICIAN PRACTICE, LLC, DBA BUFFALO TRACE GATSROENTEROLOGY, 991 MEDICAL PARK DRIVE, SUITE 203, MAYSVILLE, KY 41056
Principal Office ZIP code: 41056

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BUFFALO TRACE GASTROENTEROLOGY 401(K) PLAN 2015 205289291 2016-09-27 BUFFALO TRACE GASTROENTEROLOGY, PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6067595157
Plan sponsor’s address 991 MEDICAL PARK DRIVE, SUITE 203, MAYSVILLE, KY, 410560000
BUFFALO TRACE GASTROENTEROLOGY 401(K) PLAN 2014 205289291 2015-07-16 BUFFALO TRACE GASTROENTEROLOGY, PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6067595157
Plan sponsor’s address 991 MEDICAL PARK DRIVE, SUITE 203, MAYSVILLE, KY, 410560000

Signature of
Role Plan administrator
Date 2015-07-16
Name of individual signing DONALD WELLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-16
Name of individual signing DONALD WELLER
Valid signature Filed with authorized/valid electronic signature
BUFFALO TRACE GASTROENTEROLOGY 401(K) PLAN 2013 205289291 2014-02-28 BUFFALO TRACE GASTROENTEROLOGY, PLLC 5
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6067595157
Plan sponsor’s address 991 MEDICAL PARK DRIVE, SUITE 203, MAYSVILLE, KY, 410560000

Signature of
Role Plan administrator
Date 2014-02-28
Name of individual signing DONALD WELLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-02-28
Name of individual signing DONALD WELLER
Valid signature Filed with authorized/valid electronic signature
BUFFALO TRACE GASTROENTEROLOGY 401(K) PLAN 2013 205289291 2014-05-09 BUFFALO TRACE GASTROENTEROLOGY, PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6067595157
Plan sponsor’s address 991 MEDICAL PARK DRIVE, SUITE 203, MAYSVILLE, KY, 410560000

Signature of
Role Plan administrator
Date 2014-05-09
Name of individual signing DONALD WELLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-05-09
Name of individual signing DONALD WELLER
Valid signature Filed with authorized/valid electronic signature
BUFFALO TRACE GASTROENTEROLOGY 401(K) PLAN 2012 205289291 2013-03-18 BUFFALO TRACE GASTROENTEROLOGY, PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6067595157
Plan sponsor’s address 991 MEDICAL PARK DRIVE, SUITE 203, MAYSVILLE, KY, 410560000

Signature of
Role Plan administrator
Date 2013-03-18
Name of individual signing DONALD WELLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-03-18
Name of individual signing DONALD WELLER
Valid signature Filed with authorized/valid electronic signature
BUFFALO TRACE GASTROENTEROLOGY 401(K) PLAN 2011 205289291 2012-04-12 BUFFALO TRACE GASTROENTEROLOGY, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6067595157
Plan sponsor’s address 991 MEDICAL PARK DRIVE, SUITE 203, MAYSVILLE, KY, 410560000

Plan administrator’s name and address
Administrator’s EIN 205289291
Plan administrator’s name BUFFALO TRACE GASTROENTEROLOGY, PLLC
Plan administrator’s address 991 MEDICAL PARK DRIVE, SUITE 203, MAYSVILLE, KY, 410560000
Administrator’s telephone number 6067595157

Signature of
Role Plan administrator
Date 2012-04-12
Name of individual signing DONALD A WELLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-04-12
Name of individual signing DONALD A WELLER
Valid signature Filed with authorized/valid electronic signature
BUFFALO TRACE GASTROENTEROLOGY 401(K) PLAN 2010 205289291 2011-03-23 BUFFALO TRACE GASTROENTEROLOGY, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6067595157
Plan sponsor’s address 991 MEDICAL PARK DRIVE, SUITE 203, MAYSVILLE, KY, 410560000

Plan administrator’s name and address
Administrator’s EIN 205289291
Plan administrator’s name BUFFALO TRACE GASTROENTEROLOGY, PLLC
Plan administrator’s address 991 MEDICAL PARK DRIVE, SUITE 203, MAYSVILLE, KY, 410560000
Administrator’s telephone number 6067595157

Signature of
Role Plan administrator
Date 2011-03-23
Name of individual signing DONALD WELLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-03-23
Name of individual signing DONALD WELLER
Valid signature Filed with authorized/valid electronic signature
BUFFALO TRACE GASTROENTEROLOGY 401(K) PLAN 2009 205289291 2010-09-15 BUFFALO TRACE GASTROENTEROLOGY, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 6067595157
Plan sponsor’s address 991 MEDICAL PARK DRIVE, SUITE 203, MAYSVILLE, KY, 410560000

Plan administrator’s name and address
Administrator’s EIN 205289291
Plan administrator’s name BUFFALO TRACE GASTROENTEROLOGY, PLLC
Plan administrator’s address 991 MEDICAL PARK DRIVE, SUITE 203, MAYSVILLE, KY, 410560000
Administrator’s telephone number 6067595157

Signature of
Role Plan administrator
Date 2010-09-15
Name of individual signing DONALD WELLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-15
Name of individual signing DONALD WELLER
Valid signature Filed with authorized/valid electronic signature

Organizer

Name Role
U-B OF KENTUCKY CORPORATION Organizer

Member

Name Role
Donald A Weller Member

Registered Agent

Name Role
U-B OF KENTUCKY CORPORATION Registered Agent

Filings

Name File Date
Administrative Dissolution 2022-10-04
Annual Report 2021-02-10
Annual Report 2020-06-02
Annual Report 2019-06-30
Registered Agent name/address change 2018-02-02
Annual Report 2018-02-02
Principal Office Address Change 2017-08-18
Annual Report 2017-08-18
Annual Report 2016-03-23
Annual Report 2015-06-02

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Date of last update: 12 Nov 2024

Sources: Kentucky Secretary of State

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