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LifePoint Rehab Physician Services, LLC

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Company Details

Name: LifePoint Rehab Physician Services, LLC
Jurisdiction: Idaho
Legal type: Foreign Limited Liability Company
Status: Active-Existing
Date of registration: 15 Jul 2022 (3 years ago)
Financial Date End: 31 Jul 2025
Entity Number: 4824929
Place of Formation: DELAWARE
File Number: 831797
Principal Address: 330 SEVEN SPRINGS WAY BRENTWOOD, TN 37027-5098
Mailing Address: 330 SEVEN SPRINGS WAY BRENTWOOD, TN 37027

Manager

Name Role Address Appointed On
Pamela Kane Manager 330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027 2024-06-13
Charlotte Lawrence Manager 330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027 2024-06-13
Christopher J. Monte Manager 330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027 2024-06-13
J. Michael Grooms Manager 330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027 2024-06-13
Monica Bowman Manager 330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027 2024-06-13
David Reynolds Manager 330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027 2024-06-13

Agent

Name Role Address
C T CORPORATION SYSTEM Agent 1555 W SHORELINE DR, STE 100, BOISE, ID 83702

Member

Name Role Address Appointed On
LIFEPOINT REHAB LLC Member 330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098 2023-06-05

National Provider Identifier

NPI Number:
1598492522
Certification Date:
2023-03-27

Authorized Person:

Name:
CHARLOTTE LAWRENCE
Role:
ASSISTANT VICE PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005780419 2024-06-13
Annual Report 0005267840 2023-06-05
Registered Agent Name/Address Change (mass change) 0004897764 2022-09-12
Initial Filing 0004824929 2022-07-15

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Date of last update: 25 Mar 2025

Sources: Idaho Secretary of State