0001408997-16-000002.txt : 20160516 0001408997-16-000002.hdr.sgml : 20160516 20160516153103 ACCESSION NUMBER: 0001408997-16-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160516 DATE AS OF CHANGE: 20160516 EFFECTIVENESS DATE: 20160516 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Implantable Provider Group, Inc. CENTRAL INDEX KEY: 0001408997 IRS NUMBER: 113667807 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-263261 FILM NUMBER: 161653240 BUSINESS ADDRESS: STREET 1: 11650 HAYNES BRIDGE ROAD STREET 2: SUITE 200 CITY: Alpharetta STATE: GA ZIP: 30022 BUSINESS PHONE: 7707530046 MAIL ADDRESS: STREET 1: 11650 HAYNES BRIDGE ROAD STREET 2: SUITE 200 CITY: Alpharetta STATE: GA ZIP: 30022 FORMER COMPANY: FORMER CONFORMED NAME: Implantable Provider group, Inc. DATE OF NAME CHANGE: 20070806 D 1 primary_doc.xml X0707 D LIVE 0001408997 Implantable Provider Group, Inc. 11650 Haynes Bridge Road Suite 200 Alpharetta GA GEORGIA 30009 7707530046 DELAWARE Implantable Provider group, Inc. Corporation true James J. Ethridge, Jr. 11650 Haynes Bridge Road Suite 200 Alpharetta GA GEORGIA 30009 Director Vincent Coppola 11650 Haynes Bridge Road Suite 200 Alpharetta GA GEORGIA 30009 Executive Officer Ken Goulet 11650 Haynes Bridge Road Suite 200 Alpharetta GA GEORGIA 30009 Director Steve Nelson 11650 Haynes Bridge Road Suite 200 Alpharetta GA GEORGIA 30009 Director Dennis Antinori 11650 Haynes Bridge Road Suite 200 Alpharetta GA GEORGIA 30009 Director Gubby Barlow 11650 Haynes Bridge Road Suite 200 Alpharetta GA GEORGIA 30009 Director Mike Dixon 11650 Haynes Bridge Road Suite 200 Alpharetta GA GEORGIA 30009 Director Christopher Kersey, M.D. 11650 Haynes Bridge Road Suite 200 Alpharetta GA GEORGIA 30009 Director Other Technology Decline to Disclose 06b false 2016-05-02 false true false 0 575520 575520 0 false 2 0 0 0 false Implantable Provider Group, Inc. /s/ Mary Rountree Mary Rountree Secretary and Vice President of Finance 2016-05-16